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Re: Female Fertility Age

One in seven couples has difficulty conceiving 1: A third of each time traced to the woman or male. Otherwise, the infertility concern is traced to each partner or no cause is found. 2 Accounting for more than ninety-nine percent of all assisted reproductive technology has been in vitro fertilization (IVF). “About 48,000 IVF babies are born each year in the United States.” 3 However, in vitro fertilization risk serious health concerns for the mother when hormonal fertility drugs are administered and produce many more eggs than is needed. A new advanced technique for assisted reproduction is known as in vitro maturation (IVM). In vitro maturation is a viable fertility solution for women who meet certain criteria. This procedure eliminates health risk factors associated to IVF: Minimal or no drugs are administered, less expensive fertility solution, and reduce patient discomfort. 4 Since October 2007: “Around 400 babies worldwide have been born using IVM, compared to around 2 million IVF babies.” 5

The procedure for In Vitro fertilization (”Test tube baby” 6) begins when a fertility drug is taken in the beginning of the menstrual cycle to stimulate the ovaries to develop several mature eggs. Also, medication may be prescribed such as synthetic hormone called Lupron prevent releasing eggs to early. When an ultra sound confirms the eggs have reached mature stage: Removal of the eggs through the vaginal wall is done under anesthetic with a needle by a physician. In a laboratory the eggs are combined in a dish with the partner's sperm. After two or five days, the fertilized eggs become an embryo. A thin catheter holding two or three embryos inserted into the uterus through the cervix.”On average, you have a 35 percent chance of getting pregnant and a 28 percent possibility of delivering a baby with each cycle of treatment.” The outcome is contingent upon the age of the women (younger women have healthier eggs) and extent of the couple's fertility problems. Vitro fertilization has a thirty percent chance of having twins or more. 3

In Vitro fertilization encompasses health concerns and other issues: Up to four percent of women develop ovarian hyperstimulation syndrome (OHSS) from fertility medication, usually a couple of days after embryo transfer. Women who experience this condition have abdominal bloating and pelvic discomfort. One percent of women who have OHSS, the situation is severe enough to cause abdominal pain and fluid retention. Hospitalization is required to provide correcting the fluid imbalance with an intravenous drip and injecting pain relief medication. Besides additional treatment require: “injections of heparin to counter the tendency of the blood to clot abnormally.” Rare occasions OHSS can cause strokes and severe lung problems from abnormal blood clotting, fluid accumulation interfering with normal function of the lungs and heart, surgery to correct enlarged ovaries that twist or bruise and kidneys or liver function stops working effectively. 7 Selective reduction of pregnancy may be considered when to many fetuses develop placing an unsafe amount of stress on the women (saving her life from complications), and can endanger the fetuses as well: “The chances of complete miscarriage (25% 11) or damage to the surviving fetus(es) are very low.” 8

Procedure for in vitro maturation (IVM): Immature eggs are collected from the ovaries and allowed to mature in a Petri dish (laboratory for 48 hours 13) before being fertilized and returned to the womb.14 In Vitro Maturation is challenging procedure as described by Dr. Randy Morris (first successful IVM procedure performed in the United States): “The follicles which contain those immature eggs are less than half the size of follicles containing mature eggs. This makes them harder to spot and harder to retrieve. The immature eggs are more delicate than mature eggs. We also have to provide a special nutrient and hormone solution so those eggs can mature in a Petri dish before they're fertilized and implanted into the uterus.” 18

In vitro maturation is viable solution for fertility problems for certain women:

Women less than 35 years old

Women with polycystic ovarian syndrome (PCOS) (Major cause of infertility related to hormonal disorder. In the United States at least 5 - 10% of reproductive aged women. 10)

Women with a history of hyperstimulation on fertility medications

Women with a history of poor oocyte (egg) quality (”If the eggs are of poor quality, especially in patients over 40, oocyte donation may be needed. 11)

Women planning to have chemotherapy (Chief of Obstetrics and Gynecology Director of the McGill University Reproductive Centre, Dr. Seang-Lin Tan said referencing to eight female cancer patients undergone in-vitro maturation: “We were able to immediately remove a number of healthy eggs without delaying chemotherapy.”) 12) “4

Benefits of In vitro maturation (IVM): No fertility drugs are administered or less medication is prescribed (Saving estimated over $5,000 including blood checks 18). 9

First babies born by in Vitro Maturation:

In Britain, twins born by caesarean (at 38 weeks) on October 18, 2007, first conceived by In Vitro Maturation, Ilia (6lbs, 11ozs 16) and Isabella's (5lbs, 14ozs. 16) mother Tina, thirty. Mother had polycystic ovarian syndrome (PCOS - “cysts on the ovaries which can affect fertility.”) prevented natural child birth, IVM procedure proven successful. 15 In the United States first women pregnant using IVM Cortney Webb and her physician Dr. Randy Morris, a reproductive endocrinologist. During the procedure thirty-three immature eggs from the ovaries where removed. Subsequently, three fertilized eggs were implanted and one resulted in a pregnancy. Coney Webb and her husband were informed they are having a baby boy. “Webb said she and her husband were excited trying this, because there was little risk to me and my health.” 17

In Vitro maturation is not advisable for older women: “Their ovaries have fewer eggs, and because many eggs fail to mature in the laboratory, a high number are needed to begin with.” 13 Long term effects using immature eggs and maturing them in a laboratory is not known, but researchers believe no long term health concerns is eminent. 16

Women & Infant Center for Reproduction and Infertility among services provided include in vitro maturation (IVM) - http://www.womenandinfants.org/body.cfm?ID=91&type=patients&CFID=4901227&CFTOKEN=30158621

Expected in the future, millions of women will become knowledgeable of IVM assisted reproductive technology for genetic selection of offspring, fewer in vitro fertilization procedures will be performed. Advances in vitro maturation has increased the number of successful births in assisted reproductive technology. 14

References:

1.) Fertility LifeLines - http://www.fertilitylifelines.com/

2.) Infertility - http://www.nlm.nih.gov/medlineplus/infertility.html

3.) Fertility treatment: In vitro fertilization (IVF) - http://www.babycenter.com/0_fertility-treatment-in-vitro-fertilization-ivf_4094.bc?articleId=4094

4.) Is In Vitro Maturation right for me? - http://www.womenandinfants.org/body.cfm?id=983

5.) Twins born after new fertility treatment - http://www.guardian.co.uk/science/2007/oct/25/1

6.) In vitro fertilisation - http://en.wikipedia.org/wiki/In_vitro_fertilisation

7.) fact sheets - ovarian hyperstimulation syndrome - http://www.monashivf.com/default.asp?action=article&ID=21855

8.) Additional In Vitro Fertilization Information - http://www.ncfmc.com/consider-invitro-fertilization.htm

9.) Is In Vitro Maturation right for me? - http://www.womenandinfants.org/body.cfm?id=983

10.) POLYCYSTIC OVARIAN SYNDROME PCOS - http://www.newyorkfertility.com/polycystic-ovarian-syndrome-pcos.htm

11.) Our In Vitro Fertilization Program - http://obgyn.umc.edu/ivf.html

12.) New Method of Preserving Fertility in Young Women with Cancer - http://www.newswise.com/articles/view/505542/

13.) 'Mild' form of IVF just as effective, researchers claim - http://www.guardian.co.uk/science/2008/nov/10/ivm-ivf

14.) In Vitro Maturation Cuts Costs and Risks for Test Tube Babies - http://futurepundit.com/archives/cat_biotech_reproduction.html

15.) Our 'L95 IVF' twins: First British mother to conceive from new treatment that's bringing hope to thousands - http://www.dailymail.co.uk/health/article-1120670/Our-95-IVF-twins-First-British-mother-conceive-new-treatment-thats-bringing-hope-thousands.html

16.) In Vito Maturation - http://infertility.suite101.com/article.cfm/in_vitro_maturation

17.) New In-Vitro Treatment Shuns Shots - http://www.cbsnews.com/stories/2009/01/28/earlyshow/health/main4759856.shtml?source=RSSattr=HOME_4759856

18.) Chicago Doctor Produces Nations First IVF Baby - Without Fertility Drugs - http://www.emediawire.com/releases/2008/12/prweb1756744.htm

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