When It Comes To In Vitro Fertilization, ‘Natural’ Isn’t Better

All types of businesses and consumer brands have seized on the consumer’s desire for more “natural” products and services. Unfortunately, the word “natural” is often misused, in that it suggests that something “natural” is somehow better. But when it comes to fertility care ― specifically in vitro fertilization, or IVF – data show that isn’t the case.

According to a comprehensive study released this week at American Society for Reproductive Medicine (ASRM)’s 2016 Scientific Congress & Expo by our group Reproductive Medicine Associates of New Jersey, so-called “natural IVF” was shown to have no distinct advantages over traditional IVF.

In fact, the data from the natural IVF arm of the study, the first large-scale controlled trial of this type conducted in the U.S., showed that 24% of patients didn’t have an egg available for fertilization, and nearly 50% didn’t have an embryo available for transfer.

Natural IVF has been promoted by some fertility clinics as a less expensive approach, with the main difference between it and traditional IVF being that ovarian stimulation medications are not used to help develop multiple eggs in the ovaries. Instead, “natural” IVF seeks to retrieve a single egg without traditional stimulation medications, which then will be fertilized in the lab just like traditional IVF process.

Some hopeful patients feel that without the use of stimulation medications the process is more “natural” and somehow healthier despite any evidence. Some others feel that, given the cost of care with fertility medications, traditional IVF care is out of their financial reach.

“After undergoing both natural cycle and traditional stimulated IVF, I can wholeheartedly recommend traditional IVF to any woman seeking help in conceiving a healthy baby,” said Laura Davis, a study participant and a patient at RMANJ. “I wanted to give natural IVF a try, but realized that my best option for conceiving was traditional IVF.” Laura’s team was able to retrieve more than 20 eggs through the first stimulated ‘traditional’ cycle—eight of which were healthy embryos. One single embryo transfer and nine months later, Laura gave birth to a healthy baby girl.

“I come from a family of six and was really hurting after undergoing a failed natural IVF cycle and thinking I couldn’t have a family,” Laura says. “Just knowing that my husband and I had the opportunity to continue to grow our family with the remaining embryos through traditional IVF gives us peace of mind and makes it all worth it.”

The evidence is clear: patents in the natural IVF arm of the study had fewer eggs to fertilize, fewer available embryos to transfer, and ultimately require more time and money to achieve success versus traditional IVF care. Based on this data, we do not recommend natural IVF to patients in our program in New Jersey.

Infertility care can often be described as a marathon, where the “runner” must draw on all their strength and resources – emotional, physical, and financial – to cross the finish line. Unfortunately, too many patients in the “natural IVF” arm of this new trial never even left the starting line. Our goal ― naturally ― is to provide care that is safe, successful, cost-effective, and that also is mindful of the investment of time made by our patients.

Advertisements

Scientists test a new gene editing technique in vivo to correct one form of anaemia

Scientists at Yale University have developed a new in-vivo gene editing technique to correct mutations that cause beta thalassaemia – a form of anaemia that reduces haemoglobin production. This technology was previously limited to in-vitro cell culture studies.

Scientists published their study in the Nature Communications journal on 26 October 2016. This study is the fruit of the collaboration between Yale Medical School Laboratories and Biomedical Engineering Professors, Peter Glazer and Mark Saltzman, which dates back to 2009.

 

Raman Bahal, co-author of the study explained: “We have created a technology based on the interface of Chemistry, Biology and Nanotechnology to edit a genetic mutation in anaemic mice whilst improving the phenotype of sick mice using minimum off-target effects“.

 

The technology that has been developed involves injecting a protein into bone marrow. According to the study, this protein combined with synthetic molecules known as “PNA” bind to a “target gene” to form a triple helix and thus trigger the repair process of the defective cell causing thalassaemia.

 

By successfully editing corrective genes in mice with thalassaemia, this technique could be further investigated in order to treat human beings.

Three American states want to limit access to abortion

The American Family Planning Association (Planned Parenthood) has contested the decision taken by three states in an attempt to reduce access to abortion, namely Northern Carolina, Alaska and Missouri.

In Northern Carolina, there is a law that bans abortion after the twentieth week of pregnancy, except in a medical emergency. In Alaska, there is also a legal ban on abortion during the second trimester of pregnancy. Missouri has imposed a 72-hour waiting period between the request and the abortion per se, following in the footsteps of Oklahoma, Utah and South Dakota.

Since October 2015, the State of Arizona has obliged pharmacists prescribing the abortion pill to inform women that the effects of this medication can be reversed.

Carrie Flaxman, an American Family Planning (Planned Parenthood) lawyer explained that, “Women are obliged to travel hundreds of kilometres, cross borders, miss work, lose pay and jeopardise their health to undergo an abortion”.

Selfless sister becomes surrogate mum again to help gay brother be dad for SECOND time

A sister has helped her gay brother become a dad for the second time after becoming a surrogate once more.

Rhiannon Stevens gave birth to brother Clinton’s first daughter in 2014 after pledging to be his surrogate when he revealed he was gay 14 years ago

The 35-year-old from Melbourne, Australian, was taken up on her offer after Clinton and his partner Callum, 33, wed in 2012 and found it difficult to adopt or find a surrogate.

Using a donor egg and the couple’s sperm, Rhiannon became pregnant with their eldest daughter Zara, two, after a successful embryo transfer in 2014.

And now she’s also given birth to their second daughter, Aiden, who was born just three weeks ago, making the couple proud parents for the SECOND time.

Rhiannon said: “I’ve always said that when the time came, I’d help Clinton to have a child.

“It felt like the most natural thing in the world to offer to be his and Callum’s surrogate. I’ve never been concerned about having any difficulty handing the baby over to them at the end of the process.

“After Zara was born, it only took me three months to offer to go again. Clinton and Callum are absolutely wonderful with kids and helping them to become parents was a dream come true for me. I’d do it again in a heartbeat.”

Rhiannon, an admin officer, and her brother have always been close, both sharing a love of kids and working as babysitters in their teenage years.

She said: “We fought like all siblings as kids, but as soon as we grew up we adored each other. When Clinton came out to our family, the first thing I said was that I’d help him to have a baby when the time was right.

“I don’t think he thought I was serious at the time, but I never forgot about my promise.”

As the years rolled by, Rhiannon went on to get married and have three kids of her own, Soraya, 10, Cobie, eight, and Mahli, seven, while Clinton travelled and lived overseas.

But in 2010 he met Callum through a friend and love blossomed.

She said: “They were such great uncles to my kids. Both completely natural and offering different qualities.

“When they announced they were getting married in 2012, I knew they’d be looking to become parents soon. They’d be great dads.”

But when the loved up pair looked into the process, they quickly came to the realisation that adoption and international surrogacy were both lengthy and complicated.

Clinton Bryan-Matthieson said: “I remember on my first date with Callum I told him I wanted to be a dad one day.

“Surrogacy was complicated not allowed in some states because we’re gay while adoption could take years.

“Of course, I remembered Rhiannon’s kind offer. But it was a big deal and I wasn’t sure if I could ask for something so generous.”

The boys didn’t need to worry though, as Rhiannon once again offered to be their ‘oven’ not long after they embarked on their journey to fatherhood.

“They flew to see me in Melbourne and we went for dinner to discuss it all.

“By the end of the meal, we were celebrating with wine and pizza.”

But it took twelve long months of legal formalities, including signing a contract and undergoing intensive counselling, before Rhiannon could begin the IVF treatment to carry her brother’s baby.

Rhiannon added: “The process was slow to begin with. I was ready to go from the moment we discussed it, but we had heaps of hoops to jump through.

“Eventually though, we were given the thumbs up and doctors started prepping embryos which were made using the boy’s sperm and a donor egg.

“Amazingly, I fell pregnant with Zara on the first transfer and I knew very quickly after that I was.

“It was tough as I couldn’t tell them until the clinic had done a proper bloody test. I was having to avoid them for fear of spilling the beans too soon.”

It was an emotional and exciting time for the dads-to-be who flew backwards and forwards between Sydney and Melbourne for scans and doctor’s appointments.

Clinton said: “I was very aware that my sister was doing so much for us, so I wanted to be there for her as much as possible.

“It was very exciting watching our little girl grow and seeing Rhee’s tummy pop. We couldn’t wait for her to arrive.”

Zara was born a few days before Christmas in 2014, with both dads right by Rhiannon’s bedside.

She said: “I knew what labour was like so I warned them they weren’t in for a pretty ride.

“There were a few issues with Zara’s arrival, but the moment they saw her, they were in love.

“This little girl that had grown inside of me, was their baby and I felt so privileged to have been a part of that.

“I knew then that I’d do it again in a flash.”

When Zara was just three months old, Rhiannon offered to carry another baby for her brother and in-law.

Rhiannon said: “It was a really easy decision for me. My three kids were completely fine with the fact that their mummy had grown a baby for their uncle and I loved seeing Clinton and Callum so happy.

“It took another year or so for the process to happen again but when it did, I was over the moon.

“I loved being an aunty to Zara and couldn’t wait to help give her a sibling.”

On November 20, 2016, Rhiannon gave birth to another niece, Aiden.

She said: “This time the birth was a lot more enjoyable as there were no complications.

Both Callum and Clinton got skin-to-skin time with her just moments after she was born. It was beautiful to watch.

“Of course, people always ask me how I knew I’d be able to hand over the baby I’d carried for nine months at the end.

“I always tell them that it’s because I always knew I was carrying my brother’s baby. Not mine.

“The hardest thing about the process for me is actually saying goodbye to my brother, as I love having him around.

“Zara and Aiden are both beautiful girls, but I am very happy in my role as their aunt.”

Now Clinton and Callum are looking forward to their future as dads to two girls, and can’t quite believe their sister gave them such an incredible gift.

Clinton said: “The fact my sister helped us to become parents twice is such a testament to the woman she is.

“Becoming dads for the second time is a gift we can never repay and we’re looking forward to explaining to Zara and Aiden exactly how they came into the world when they’re old enough.”

Woman gives birth using ovary frozen during childhood because she needed chemotherapy

Moaza Al Matrooshi, 24, is believed to be the first person in the world to deliver a baby after having her ovary cryopreserved

A woman gave birth using an ovary she had cryogenically frozen during childhood because she needed chemotherapy.

Moaza Al Matrooshi, 24, is thought to be the first person in the world to deliver of a baby after having the ovary removed during puberty and retransplanted as an adult.

Ms Al Matrooshi, originally from Dubai, was eight when she had the organ retrieved before having chemotherapy and a bone marrow transplant for the inherited blood disorder Beta Thalassaemia.

As she had not entered puberty, she could not have IVF treatment to allow her ovaries to produce eggs.

Her remaining ovary was only partially functioning following the chemotherapy and she went into early menopause.

Doctors decided to transplant the frozen ovarian tissue back into Ms Al Matrooshi when she was 21 to give her a chance of conceiving using her own eggs.

Ms Al Matrooshi then underwent IVF treatment at CARE Fertility with her partner Ahmed and, aged 24, gave birth to a baby boy at the Portland Hospital on Tuesday.

Rob Smith, clinic director at CARE London, said the birth represented a “landmark in fertility preservation treatment for young girls who risk irreversible ovarian damage following necessary treatments for diseases such as cancer”.

“Moaza has become the first woman in the world to give birth following the transplant of her own ovarian tissue removed before puberty.”

He said her story was a “beacon of hope to all women who face the prospect of infertility due to invasive treatments at a young age” and sent his “warmest congratulations” to the new family.

“We believe this case is an incredible example of how far IVF has come. In the 15 years since Moaza’s ovary was frozen, the success rates for IVF have improved dramatically allowing her to have an excellent chance of achieving a successful pregnancy.”

Prof Adam Balen, chair of the British Fertility Society, said: “This is a ground-breaking step in this area of fertility preservation and has the potential to help many young people who face cancer treatment preserve their fertility chances in the future.

“Storing ovarian tissue was pioneered 20 years ago and now the results are coming through.

“Chemotherapy and radiotherapy can have serious side effects on the reproductive organs.

“Storing ovarian tissue and more recently storing testicular tissue is becoming more mainstream but we need more centres providing this service and it is important that a multi-disciplinary team of experts is involved to ensure young people in particular are offered this as an option.”

How Does the Egg Donation Process Work?

Egg donation is a process where an egg, or oocyte, is removed from a fertile woman and donated to another woman in order to help her conceive. It is a part of assisted reproductive technology, or ART.

Donated eggs are typically fertilized in a laboratory. The resulting embryos are then transferred into the recipient’s uterus using a procedure such as in vitro fertilization (IVF).

Alternatively, some or all of the embryos may be frozen for later use, or some may be transferred to other women.

This type of fertility treatment is generally given to women who cannot use their own eggs for various reasons, such as ovarian failure, to avoid genetic defects, or advanced age.

According to the Centers for Disease Control and Prevention (CDC), egg donation has a relatively high success rate. In 2012, over 55 percent of transfers involving fresh embryos from donor eggs resulted in a live birth.

Who can donate eggs?

Several factors affect a woman’s ability to donate eggs. Although different egg donation programs set different qualifying criteria, the American Society for Reproductive Medicine (ASRM) list some common qualities that women who donate will require.

Women of a younger age are preferable. Generally, donors are between 21 and 34 years of age. Women in this age group tend to respond better to fertility drugs, and they tend to have a higher quality and quantity of eggs.

These factors increase the likelihood of pregnancy and reduce the risk of birth defects.

Donors should be free of infections, such as HIV and hepatitis C, they should not be carriers of the cystic fibrosis gene, and they should not be at risk of inherited disease.

Women may not be eligible to donate if they are at increased risk of exposure to HIV or other infections, for example, through drug use or prostitution. Equally, they may not be able to donate if they cannot produce a detailed family medical history.

Some programs favor women who have already successfully donated eggs, or who have given birth.

Egg donor screening

Reputable programs offer a rigorous screening process to minimize the risk of birth defects and other complications.

The United States Food and Drug Administration (FDA) issue guidelines to help fertility clinics to decide on the eligibility of an egg donor.

A program’s screening process may include several, or all, of the following steps:

  • Application
  • Interview, by telephone or in person
  • Physical examination
  • Blood tests
  • Drug tests
  • Ultrasound, to examine the reproductive organs
  • Medical and psychological history – to discover donor and family health history
  • Infectious disease screening
  • Screening for inherited disease

Psychological screening

Donating an egg can be an emotional experience for the donor, as well as for the intended parents.

Reputable egg donor programs include a thorough psychological screening of both parties. This may involve psychometric testing of prospective donors.

Evaluation of the donor’s mental health is vital to ensure the health of any resulting children, and to be sure the donor is making an informed decision before beginning the donation process.

What to expect with egg donation

After being selected and completing the screening and legal procedures, egg donors may be prescribed medication to stop their normal menstrual cycle.

Side effects can include hot flashes, headache, fatigue, and body aches.

The donor will then be prescribed a series of fertility drugs to stimulate her ovaries to produce several eggs at once. This is known as hyperstimulation. Donors will have to self-administer this medication by injecting it under their skin or into a muscle.

Some women may experience mild side effects such as bruising at the injection site, mood swings, and tender breasts. In rare cases, a woman may develop severe ovarian hyperstimulation and hospitalization will be necessary.

As there is a risk of pregnancy before the eggs are retrieved, it is best to avoid intercourse, or use a barrier contraceptive, such as a condom.

Throughout the donation cycle, a donor will have to undergo frequent blood tests and ultrasound examinations to monitor their reactions to the medications.

During extraction

Shortly before the eggs are to be retrieved, the donor will be given a final injection in preparation for the removal of the eggs.

The doctor will perform a medical procedure called a transvaginal ovarian aspiration to remove the eggs from the ovaries. The doctor will insert an ultrasound probe into the woman’s vagina and use a needle to remove the egg from each follicle.

A donor may be given painkillers, sedatives, or an anesthetic during the procedure, which lasts around 30 minutes.

As this is a minor procedure, an overnight stay at the clinic or hospital is unnecessary.

After donation

Some women find it takes several days of rest to recover after the transvaginal ovarian aspiration, while others return to normal activities the next day.

Some programs provide aftercare to donors, but others do not. As the donation process can have a psychological impact, some women may find it useful to work with a counselor or psychotherapist.

Risks and side effects

The risks of egg donation are relatively low. The procedures and medications used for egg donors are the same as they are for women using their own eggs in the IVF process. They carry the same level of risk.

There is a small risk associated with the use of anesthetic during the egg retrieval process, but serious problems are uncommon.

Some women may experience bleeding when the needle is inserted into their ovary. In rare cases, there may be damage to the bowel, bladder, or nearby blood vessels. However, serious damage or severe bleeding is unlikely.

There is also the possibility of infection following the removal of the eggs. Antibiotics may be prescribed to prevent this.

Sometimes, the drugs prescribed can cause ovarian hyperstimulation syndrome (OHSS).

OHSS occurs when too many eggs develop in the ovaries. It can be mild, moderate, or severe. In all cases, a doctor should be consulted. Severe cases may require hospitalization, with symptoms including difficulty breathing, rapid weight gain, stomach pain, and vomiting.

Legal implications for egg donors

The legal status of egg donation varies by country. In the U.S., it is legal for a woman to donate eggs either anonymously or not. It is also legal to receive financial compensation for donating eggs.

Egg donation clinics will require all donors to sign a contract to ensure they have no legal rights or responsibilities to any resulting children or embryos.

The woman who receives the egg, although not biologically related to the child, will physically give birth to any resulting offspring and she will be recorded as the birth mother.

Donor identity

In the U.S., donors may be anonymous, or they may know or get to know the recipient.

Many egg donation programs keep the donor’s identity confidential. The intended parents will receive certain information about the donor, but they will not meet each other or know one another’s names.

Other programs may allow donors to meet recipients if both parties are willing. In some situations, donors may give permission to be contacted once the child reaches a certain age.

In other cases, the donor may already have a relationship with the intended parents. This occurs if a woman asks a friend or family member to donate an egg. In these situations, it is recommended to contact a clinic or donation program to arrange the screening, treatment, and transfer process.

 

Embryo Freezing: What You Need to Know

Embryo freezing is a procedure that allows embryos to be preserved for later use. The first successful pregnancy resulting from freezing a woman’s healthy embryos was in the 1980s. Since then, many embryos have been frozen for later use.

The embryos may be stored to enable a future pregnancy, to donate to others, for medical research or for training purposes.

The process begins by using hormones and other medications to stimulate the production of potentially fertile eggs. The eggs are then extracted from the woman’s ovaries to either be fertilized in a lab or frozen for later use.

Successful fertilization may lead to at least one healthy embryo, which can then be transferred to the woman’s womb or uterus. Hopefully, the embryo will develop and the woman can carry the developing infant through pregnancy to a live birth.

Since fertilization often results in more than one embryo, the remaining embryos can be preserved through freezing.

What is an embryo, and how is one created?

According to the Oxford Living Dictionaries, an embryo is “a human offspring during the period from approximately the second to the eighth week after fertilization.”

Before freezing can take place, suitable embryos have to be created. To create an embryo in the laboratory, the eggs must first be harvested and fertilized.

First, the woman will be given hormones to make sure she ovulates correctly. She is then given fertility medications to increase the number of eggs she produces.

In the hospital, a doctor will extract the eggs, using an ultrasound machine to ensure accuracy. The eggs may be frozen or used at once.

If the woman wishes to become pregnant at once, in vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI) may be used to fertilize the egg.

During the process of IVF, the eggs are exposed to sperm and the mixture is cultured in a laboratory. Fertilization may take 16 to 20 hours. The fertilized eggs are called embryos.

An embryologist will monitor the development of the embryos over the next 6 days, after which a suitable embryo may be chosen for implantation.

In ICSI, once the eggs have been extracted, a single sperm is injected directly into an egg. This may be done if there is a problem with the sperm or if past attempts at IVF have been unsuccessful.

While one embryo can be used for pregnancy, others may be frozen.

How is an embryo frozen?

The main goal of embryo freezing is to preserve the embryo for later use. The biggest problem is the water within the cells. When water freezes, crystals can form. This expansion can burst the cell, causing it to die.

To prevent this happening, the water in the embryo’s cells is replaced with a protective substance called a cryoprotectant. The embryos are left to incubate in increasing levels of cryoprotectant before they are frozen.

Once most of the water has been removed, the embryo is cooled to its preservation state through one of two methods of embryo freezing:

  • Slow freezing: This involves protecting the embryos from damage in sealed tubes and then slowly lowering the temperature in the tubes. This prevents the embryo cells from aging and becoming damaged. Embryos can last much longer in their frozen state than in their fresh state. However, slow freezing is time-consuming, and it requires expensive machinery.
  • Vitrification: In this process, the cryoprotected embryos are frozen so quickly that the water molecules in the embryos do not have time to form ice crystals. This helps to protect the embryos and to increase their survival rate during thawing.

After freezing, the embryos are stored in liquid nitrogen until they are needed for future use.

Success rates of thawing frozen embryos

The process of thawing an embryo is relatively successful. Some research has indicated that embryos frozen through vitrification have a better chance of survival, both at the freezing stage and during thawing.

Side effects of embryo freezing

Any risks and side effects involved in embryo freezing usually happen during the process of extracting the eggs from the woman’s body.

Common side effects from extracting embryos for freezing are typically mild and temporary.

They include:

  • Cramping or bloating
  • Feelings of fullness
  • Bleeding
  • Changes in vaginal discharge
  • Infection
  • Overstimulation of the ovaries

How long can embryos be frozen for?

In theory, a correctly frozen embryo can remain viable indefinitely. The embryos are held in sealed containers at temperatures of -321ºF. At this temperature, almost no biological processes such as aging can occur.

There are examples of successful pregnancies that have resulted from eggs that had been stored for up to 10 years. There is no long-term research into embryo freezing, because this procedure has only been carried out since 1983.

Some countries choose to regulate the length of time an embryo can be stored. Freezing and storing embryos is also expensive, and each clinic has its own rules about what happens if a woman can no longer use her own embryos or keep them frozen.

Frozen or fresh embryos?

A study posted in the International Journal of Reproductive Medicine looked at the results of over 1,000 cases of embryo transfer using either fresh or frozen embryos.

The results found no statistical difference between using fresh and frozen embryos for transfer. The study noted that frozen embryos could also be used for additional embryo transfers in the future while fresh embryos could not.

Other research suggests that frozen embryo transfer may be better than with fresh embryos. A recent study compared fresh and frozen embryo transfer. The results indicate that frozen embryo transfer is associated with a higher rate of pregnancy, and better outcomes for both the mother and the embryo.

Who is embryo freezing best for?

Embryo freezing can be used by any woman, but there are certain groups who may find it more beneficial than others.

These include women with genetic disorders of ovarian sensitivities, those who are due to undergo chemotherapy, and those who take medications that affect fertility.

Women who are approaching advanced reproductive age and are not ready for children yet may also benefit from freezing embryos for later use.

“Freeze-all” cycles

In a “freeze-all” cycle, the embryo is extracted from a woman’s body to be frozen for storage.

This procedure may be offered to women who have a higher risk of ovarian stimulation syndrome. This rare and potentially dangerous condition happens when a woman is receiving stimulating hormones to increase egg production.

There are ways to reduce the chance of developing this condition. For example, doctors may freeze the embryos and transfer them when the woman’s ovaries are no longer stimulated.

Women who are going to receive a medical treatment that may affect their ovaries, such as chemotherapy, may choose to store their embryos.

Sometimes, a “freeze-all” cycle is used to test an embryo for a genetic disorder. This involves removing a few strands of DNA from the embryo and testing their chromosomes. Embryos with a standard set of chromosomes are more likely to have a successful implant. Pre-screening can ensure that future offspring have a lower chance of developing genetic diseases.

Woman becomes mother to her OWN grandchild as surrogate for daughter left infertile by cancer treatment

Hairdresser Julie Bradford, 44, says she feels lucky “to have been given the chance to put things right” after several years of bad news and worry over daughter Jessica’s illness

A woman has become mother to her own grandchild – by having a surrogate baby for her daughter left infertile by cancer treatment.

Brave Julie Bradford, 44, says she feels lucky “to have been given the chance to put things right” after several years of bad news and worry.

Daughter Jessica, 21, had her eggs frozen three years ago before the treatment began – and now her own mother has given birth to her healthy baby three years later.

Baby Jack was born weighing 6lb 10oz to Julie – who is now BOTH his birth mother and proud grandmother.

Proud Jess said: “My mam is the most brave and amazing woman in the world. I love her so much for giving me my son.

“From a young age I longed to become a mother and our dream has come true.

“Jack is perfect in every way.”

Jess, of Rhymney, Gwent, was rushed to hospital in 2013 – when she claims doctors told her she was too young to have cancer.

Indeed, initially she was told she had a sexually transmitted disease and only further tests revealed the truth.

Mobile hairdresser Jess said: “At hospital I had a biopsy and within three days they told me that I had cancer.

“It took two weeks before they knew how far it had spread.

“After a scan confirmed that the cancer was in my lymph nodes and I was told that I would never have children.”

But doctors gave her chance to freeze her eggs for a chance of a baby in the future – and her brave mother offered to be her surrogate.

Jess said: “They managed to take 21 eggs before I started chemo but only 10 survived and they were made into embryos and grown for two weeks then frozen.

“Then in May this year we had an embryo defrosted and implanted into my mother’s womb for her to be the little oven helping our Jelly Bean grow.”

Jess and husband Rees Jenkins were delighted when Julie became the surrogate – and were there when little Jack was born on December 2.

She announced the birth on Facebook and told her friends: “We are very proud parents.”

Jess is now in remission and attends regular check ups and scans to ensure the cancer has not returned.

She is also campaigning for smear tests for young women to spot health problems earlier.

Her hairdresser mum Julie – who has three children of her own – said: “The last three years have been the absolute worst.

“But I was lucky enough to have been given the chance to put things right.

“I watched Jess in such agony and so full of fear and I just wished I could take her place.

“There was nothing I could do to help and it felt like the cancer was in control and I felt useless.

“I’ve always known from a young age Jess has longed to become a mother just like I did.

“When cancer took the chance away for her to carry her own child away we were all heartbroken.

“I decided that if I could be Jess’ surrogate then I would have the control again.

“I was given the chance to carry Jessica and Rees’ child and it was an honour.

“We’ve spent a lot of time in hospitals and it has become normal to us.

“I’m just so happy that this last visit was for such a wonderful reason.”

 

Exercise and infertility: What regimen is best for sperm quality?

Research, published this week in the journal Reproduction, investigates the effects of various exercise regimens on overall sperm quality. The results show that just a few months of activity can make a significant difference.

An estimated 1 in 3 couples find conceiving difficult because of poor semen quality.

Often, these couples only have in vitro fertilization (IVF) as a treatment option; however, poor sperm quality is known to increase the risk of miscarriage, birth defects, and childhood cancer.

Because of this, ways to naturally increase sperm quality are important for the health and well-being of current and future generations.

Advice given to men to improve sperm quality includes eating well, reducing alcohol intake, quitting smoking, and exercising regularly.

Although this is the standard mantra, evidence for the impact of exercise on sperm quality has, to date, been contradictory.

Some studies have shown that intense exercising – such as endurance cycling and long-distance running – can reduce sperm quality.

Conversely, other studies have found that certain types and durations of exercise have a positive impact on sperm quality.

Exercise interventions and sperm quality

A team of scientists, from Uremia University in Iran, set out to investigate the effects of exercise intensity on a range of sperm parameters.

In total, 261 healthy men, aged 25-40, were included in the study. At baseline, none of the men followed a regular exercise plan or did more than 25 minutes of exercise more than 3 days each week.

The men were split into four experimental groups:

  • Moderate-intensity continuous training (MICT) – running on a treadmill for 25-30 minutes, 3-4 days per week
  • High-intensity continuous training (HICT) – running on a treadmill for 50 minutes-1 hour, 3-4 days per week
  • High-intensity interval training (HIIT) – 1-minute bursts of treadmill sprinting followed by 1 minute of recovery, repeated 10-15 times
  • Control group – no exercise.

Each routine was followed for 24 weeks. Semen samples were evaluated before, during, and after the exercise period to assess sperm count, motility (the ability of the sperm to move), morphology (size and shape), levels of inflammatory markers, and their response to oxidative stress.

The role of oxidative stress – specifically reactive oxygen species – is a growing area of focus in fertility research. Although reactive oxygen species are vital in the fertilization process under normal conditions, if they are not under tight physiological control, they can negatively impact the overall quality of sperm.

Changes in semen following exercise

All exercise groups, when compared with the controls, had improved sperm quality across all measures. The best performing of the three experimental groups was the MICT exercise group; compared with the controls, MICT had:

  • 8.3 percent more semen volume
  • 12.4 percent higher sperm motility
  • 17.1 percent improved sperm cell shape/morphology
  • 14.1 percent more concentrated sperm
  • 21.8 percent more sperm cells.

These results are impressive, but the changes were not long term. Measures of sperm count, shape, and concentration dipped back toward pre-training levels 1 week after the exercise regimen had ended; sperm motility dropped back after 30 days.

“Our results show that doing exercise can be a simple, cheap, and effective strategy for improving sperm quality in sedentary men. However, it’s important to acknowledge that the reason some men can’t have children isn’t just based on their sperm count. Male infertility problems can be complex and changing lifestyles might not solve these cases easily.”

Lead author Behzad Hajizadeh Maleki

The authors note that a loss of weight during the exercise plan might well have been an important factor in the improvement of sperm quality. They also believe that MICT had a particularly positive effect by reducing the teste’s exposure to inflammatory agents and oxidative stress.

The next step for the Iranian team will be to see if these measurable changes in sperm quality will translate into an increased ability to fertilize. As further research is conducted to back up these findings, in the future, sperm-specific training packages could hopefully be designed, raising the chances of fertilization without medical intervention.

Fertilized egg cells trigger, monitor loss of sperm’s epigenetic memory

Scientists from the Institute of Molecular Biotechnology (IMBA) in Vienna, Austria, have discovered how an embryo’s genomic integrity is safeguarded during the first 24 h after fertilization. Insights into this mechanism have implications for improving in vitro fertilization.

The events triggered when sperm meets an egg are not only life changing for the parents but deeply fascinating from a scientific point of view, too.

The mother of all cells

Following fertilization, DNA from the mother’s egg cell and the father’s sperm cell constitute the genetic blueprint of the single-cell embryo or zygote. The incoming paternal DNA contains modifications that facilitate an “epigenetic memory” of its sperm state. Proteins provided by the fertilized egg act to largely erase this memory in order to generate a totipotent embryo that can give rise to a whole new individual. The mechanisms underlying natural reprogramming to totipotency are remarkably efficient but remain poorly understood. “To put this into perspective, reprogramming to induced pluripotency in cell culture takes several days to weeks whereas reprogramming to totipotency in zygotes occurs in less than 24 h,” says Kikuë Tachibana-Konwalski, who devotes her laboratory’s research to understanding the molecular secrets of egg cells and zygotes.

New life, new epigenetics

Reporting research in the scientific journal Cell, Vienna-based scientists from the Institute of Molecular Biotechnology (IMBA) have discovered that not only do fertilized egg cells trigger epigenetic reprogramming of sperm DNA but this process is closely monitored to safeguard genomic integrity.

“When the sperm enters the egg cell, the densely compacted male chromatin has to be entirely ‘unpacked’ and restructured around protein scaffolds called histones,” explained Sabrina Ladstätter, first author of the study. “Using fertilized mouse eggs, we showed that the egg cell actively triggers demethylation of the paternal DNA — in other words, it initiates epigenetic reprogramming by stripping any previous epigenetic memory passed on from the father. This allows the zygote to start afresh and create its own epigenetic memory and life history. This process is not without risks: demethylation can cause lesions in the DNA that can be fatal for the new organism. It is known that these lesions can lead to chromosome fragmentation, embryo loss or infertility.”

A molecular checkpoint

The researchers identified a surveillance mechanism that not only monitors DNA lesions caused by epigenetic reprogramming but also fixes the damage. They revealed that lesions in the paternal DNA caused by demethylation activate a zygotic “checkpoint” that prevents cell division until these lesions are repaired. This mechanism therefore ensures that reprogramming is completed within one cell cycle and protects genomic integrity at the volatile single-cell embryo stage. Interestingly, they also found that the conditions under which embryos are cultured affect the stringency of the checkpoint response.

Hope for better IVF treatments?

“Our findings have potential implications for improving in vitro fertilization techniques,” said Kikuë Tachibana-Konwalski, senior author of the study and a group leader at IMBA. “It will be exciting to explore how cell culture conditions enhance the zygote’s intrinsic surveillance and repair mechanisms, thus leading to better quality embryos and potentially more successful pregnancies.”