IVF

Safety drive to stop IVF clinics putting profit before embryos

Action on safety at IVF clinics has been ordered by ministers after a wide-ranging review of the fertility industry.

 An expert study raised fears that some clinics may be offering techniques that put the embryo at risk for their own profit.

In the future, all clinics will have to publish the number of complications suffered by their patients.

The review, carried out by Dr Justin McCracken, the former head of the Health Protection Agency, was ordered to reduce the cost of regulating the fertility industry, which has grown rapidly in recent years.

However, he made a series of recommendations on how patients should be dealt with when they have fertility treatments, all of which have been accepted by ministers....

It highlighted a new technique, known as Pre-Implantation Genetic Screening (PGS), as one which is possibly being offered inappropriately for commercial reasons.

For a fee, which can run into thousands of pounds, clinics can check embryos created by a successful IVF cycle for certain genetic abnormalities and only implant those that appear normal....

 Dr McCracken said the jury was still out on whether PGS improves the chances of having a baby and warned there is a risk of harm to the foetus. He said it was vital that the regulator checks that clinics are not simply recommending it to boost profits.

“I was told that the scientific evidence base for the use of PGS is not strong despite the fact that the technique has been offered for a number of years,” he said.

“I understand that there is no clinical consensus regarding its efficacy, but there is a real risk to the embryo in carrying it out.”

We found that current IVF rules on issues such as storage limits and destruction practices are intrusive and disrespectful. Mandatory time limits in some states compel destruction of stored embryos after ten years, for instance, while rules in other states prevent a surviving partner from deciding on the use or donation of embryos.

We don’t believe that embryos should be granted a moral or legal significance in and of themselves as distinct entities. Rather, their value is relational – embryos matter because of what they mean to those for whom they were generated. This meaning is intensely personal, and infinitely variable.

But a new study has found that, for those who go on to adopt, the earlier heartbreak can ultimately make for a happier family.

A study in Sweden found that couples who had adopted children after the disappointment of failing to conceive through fertility treatment appeared happier not only than other adoptive parents but even those who had children through natural means.

"The results show that it can be important to consider adoption as soon as couples seek medical help for infertility, especially now that we know that adoption enhances quality of life.

"As things stand, the issue of adoption is pursued only once IVF treatment has failed."

The researchers said it suggested that childless couples should be urged to consider adoption at a much earlier stage. It is a finding which boost the education secretary Michael Gove's drive to increase adoption rates in the UK.

It's temping to label Ryan a madwoman, as many critics have. But that's exactly wrong. Ryan represents the next wave of industrial rationality. She's bringing the innovations of Costco and Burger King to the business of human flesh....

Ryan argues that by using a manufactured embryo instead of a leftover IVF embryo, you can avoid "the discomfort of involving the biological parents." No need to worry that they're "a family somewhere." They've never met each other, much less the embryo. All they sold were eggs and sperm. "I am not emotionally attached to my eggs," says a donor quoted on Ryan's Web site as a model of suitability. "I am not giving my couple a baby." The easiest child to acquire, like the easiest child to abuse, is one who belongs to nobody.

The trouble with adoption agencies that handle leftover embryos is that they don't see it this way. They treat embryos like babies. That's why they screen you, to make sure the embryo will be in good hands. To evade this scrutiny, Ryan calls her service embryo "donation" instead of "adoption." The linguistic change is morally and legally pivotal. Adoption is what happens to babies. Donation is what happens to eggs and sperm. "Embryo donation" is a declaration that embryos should be treated like eggs and sperm—subject to purchase, screening, sale, and disposal—not like babies. [emphasis mine]

"When a child is begotten through the conjugal act, he comes to be as a gift from God, a gift crowning the spouse's mutual gift of themsleves to each other.  When a child is 'produced' it comes to be, not as a gift from God, which in truth it is, but as a product of human control."

“It happens on a day-by-day basis with casual indifference. This sheer destruction of human embryos – most people would not know that it took place on such a scale."

The Inter-American Court of Human Rights (IACHR) has overturned a prohibition on IVF in Costa Rica saying that it infringed provisions under the American Convention on Human Rights.

The ban was originally implemented by the Costa Rican Government in an effort to protect human life. Costa Rica’s Supreme Court ruled in 2000 that the practice of discarding ‘spare’ embryos in IVF was unconstitutional as it infringed the right to life under article 4 of the American Convention of Human Rights, which states: ‘Every person has the right to have his life respected… from the moment of conception’. It said IVF also violated the Costa Rican constitution....

Nine infertile couples petitioned the Inter-American Commission on Human Rights in 2001 against the ban, which issued a statement indicating that Costa Rica’s prohibition infringed a number of rights. The IACHR heard the case in September last year and published its decision, dated 28 November, at the end of the year.

It ruled that Costa Rica’s prohibition on IVF violated the rights to privacy and family, and also infringed the principle of non-discrimination. It said infertility was a disease recognised by the World Health Organisation and that infertile people should be granted access to fertility treatment. It was disproportionate to require infertility couples to seek treatment abroad. Crucially, the IACHR said an embryo could not be a ‘person’ and considered that the ‘moment of conception’ occurs after implantation, and not fertilisation.

“The court appears to have radically changed the legal definition of conception, and is applying an artificial description to a natural process. Indeed, this could have a far reaching impact.”

Piero Tozzi, legal counsel with the Alliance Defending Freedom, an organisation of Christian leaders, said: ‘A preliminary reading of the ruling indicates that the Court elevated secondary rights-such as the right to privacy, a right to personal autonomy, and a right to sexual and reproductive health-above the right to life, which by necessity takes precedence over all the other rights’.

In the cutthroat field of fertility treatments, Dr. Ernest Zeringue sharply cuts costs by creating a single batch of embryos, then divvying it up among several patients. One 'horrified' critic calls it the 'commodification of children.'

Dr. Ernest Zeringue was looking for a niche in the cutthroat industry of fertility treatments.

He seized on price, a huge obstacle for many patients, and in late 2010 began advertising a deal at his Davis, Calif., clinic unheard of anywhere else: Pregnancy for $9,800 or your money back....

Zeringue sharply cuts costs by creating a single batch of embryos from one egg donor and one sperm donor, then divvying it up among several patients. The clinic, not the customer, controls the embryos, typically making babies for three or four patients while paying just once for the donors and the laboratory work.

People buying this option from Zeringue must accept concessions: They have no genetic connection to their children, and those children will probably have full biological siblings born to other parents.

Inside the industry, Zeringue's strategy for making embryos on the cheap has spurred debate about the ethical boundaries of creating life.

"I am horrified by the thought of this," said Andrew Vorzimer, a Los Angeles fertility lawyer alarmed that a company — not would-be parents — controls embryos. "It is nothing short of the commodification of children."

...Before the clinic makes a batch of embryos, it sends an extensive profile of a sperm donor and an egg donor to prospective parents.

Once the clinic gets buy-in from a few patients, it purchases the sperm from a sperm bank, harvests eggs from the egg donor and combines them in the laboratory.

A single pairing can result in a dozen embryos, and the clinic keeps the extras frozen while it looks for patients who want them.

"We want to keep the embryos moving," Zeringue said. "The goal is not to create a bank."

Doctor calls for debate on using frozen versus fresh embryos for IVF procedures

—New evidence from a study done by Aberdeen University showing that using frozen embryos implanted in the womb instead of those implanted fresh tends to reduce the risks for both mother and child, have led to calls for a debate on whether all embryos should be frozen before use in all IVF procedures. The study, conducted by examining the records of 13,000 pregnancies that came about as the result of IVF procedures, has been printed in the journal Fertility and Sterility, and is to be presented at an upcoming science festival by lead researcher Dr Abha Maheshwari. In examining the records, the team found that when frozen and thawed embryos were used in IVF procedures, the risk of bleeding over the course of the pregnancy was thirty percent lower than if fresh embryos were used; similarly, they found there was thirty to forty percent less chance of a low weight birth, twenty percent less likelihood of the baby being born early, and twenty percent less chance of the baby dying after birth. The research didn't turn up any definitive reasons for the differences in complication rates for frozen versus fresh implantation results but suggest that it might be either due to the fact that only stronger embryos survive the freezing process, or more likely the impact of the IVF process on the woman's body.

And, in fact, each bill that arrives in the mail is a step closer to that foreboding 10-year mark when we'll have to decide the blastocyst's fate, as is the case under NSW and Victoria's assisted reproduction laws. Strange, but it feels almost as if we're being asked to choose a favourite child....

Of course, it breaks my heart. All I know is that, with each passing year, this trembling promise of a life becomes more and more a measure of my vacillation and despair.

In 1978, the first child conceived by IVF was born. In the following 33 years, numerous technologies and techniques have been developed to further aid the ability to achieve pregnancies in couples for whom natural conception has failed. However, these techniques have rarely been robustly tested and approved before they are routinely offered to infertile couples. In other cases, a development in our scientific understanding of a technique has failed to be quickly incorporated into clinical changes. This raises the concern that some of the techniques offered to some patients offer little or no benefit, and in the worse cases is not confirmed to be safe. This is a particular concern as many of the techniques discussed here are often reserved for already vulnerable patients, such as those with recurrent IVF failure. [Emphasis added]

Scientists suspect that embryos that have developed in petri dishes are slightly different in some ways from embryos that develop in the womb, but they are still working out the specifics. They have some indications that IVF embryos are more likely to have certain genetic diseases and developmental problems. but they still need more data.... In other words, if you're an IVF child, then you are a walking human experiment. Scientists are waiting to see what will happen to you as you get older, so that they can complete their data collections on the effects of IVF on people.  

Sounds really ethical, doesn't it?

Current techniques do not ‘cure’ infertility, they just overcome it... The most appropriate focus of future research may be to restore fertility.

The figures show that 3,144,386 embryos have been created in UK laboratories since the passage of the 1991 Human Fertilisation and Embryology Act. A total of 1,455,832 embryos were discarded in the course of treatment, 101,605 were given for research in destructive experiments, and 764,311 were frozen for later use.

The rest were implanted, resulting in 94,090 births, meaning that in the region of 32 embryos are created for every live birth.

OHSS [ovarian hyperstimulation syndrome] is a little-known complication of fertility treatments that rely on high doses of hormones, which are standard in the United States and the United Kingdom; the syndrome is not the only health problem to be linked to in vitro fertilization. Fertility clinics in Europe and Japan have turned to a safer, low-dose form of IVF, but clinics here have largely resisted on the grounds that the success rates for low-dose IVF are not as high.

“Pregnancy rates are lower, and more cycles of IVF are necessary” with low-dose IVF, said Dr. Glenn L. Schattman, a fertility doctor at NewYork-Presbyterian/Weill Cornell Medical Center and president of the Society for Assisted Reproductive Technology.

But some critics are urging the industry to reconsider.

“Mild stimulation is clearly much healthier for women,” said Francine Coeytaux, founder of the Pacific Institute for Women’s Health, a nonprofit organization based in Los Angeles. “The reason hyper-stimulation happened is because these fertility clinics compete against each other by posting their success rates.”

According to the National Institutes of Health, high-dose stimulation leads to OHSS in 10 percent of IVF patients. The ovaries become swollen and, as in Ms. Demidon’s case, can leak fluid into the chest and abdomen. Symptoms can range from mild to serious; in rare cases, OHSS can be life-threatening.

A recent inquiry into maternal deaths in the United Kingdom found that OHSS following high-dose IVF is now one of the leading causes of maternal mortality in England and Wales.

One recent study suggested that high-dose IVF contributes to lower birth weights, compared with the babies of women who receive minimal doses of hormones. And experts have debated for decades whether IVF contributes to an increased risk of breast and ovarian cancer; studies have reached conflicting conclusions.

Lupron, used to suppress the ovaries, has raised concerns as well. The drug is approved to treat prostate cancer; its use in IVF is off-label (meaning it is not FDA-approved for this purpose). Thousands of women have reported adverse reactions, including memory loss, liver disorders, bone loss and severe muscle, joint and bone pain, said Marcy Darnovsky, associate executive director of the Center for Genetics and Society, a public interest group in Berkeley, Calif.

“Lots of drugs are used off-label, but is this use appropriate?” said Ms. Darnovsky. “Considering the number of women who’ve taken these drugs over the past 25 years, you’d think much more rigorous studies and analysis would have been done on them.”

After struggling for years to have children the McCrea family had their prayers answered, and then some, thanks to In Vitro Fertilization. Now the family is sharing their extra blessings....

Deb had nearly signed on the dotted line to donate those leftover 18 embryos to a fertility clinic, but something just didn’t seem right.

“When my daughter was born, I went months and months just thinking I just don`t want to sign, I`m just not ready to sign them yet,” Deb explained, “I don`t want to give up that right to see pictures of that child and compare that child to ours, and see what they would have looked like and if they`re healthy and happy, so I always kind of pushed them to the side on the counter.”

So Deb took matters into her own hands, with the goal of fulfilling her other dream of surrogacy- in a different way.

Babies conceived through certain fertility treatment techniques are about one-third more likely to have a birth defect than babies conceived without any extra help from technology, according to a review of several dozen studies....

For more than 124,000 children born through IVF or using ICSI, in which a single sperm is injected directly into the egg, the risk of having a birth defect was 37 percent higher than that of the other children, they found.

"Children conceived by IVF and/or ICSI are at significantly increased risk for birth defects, and there is no risk difference between children conceived by IVF and/or ICSI," the team wrote....

"(The report) confirms what most people accepted anyway, that, yes, there is an increased risk in congenital abnormality associated with assisted reproductive technology," said William Buckett, a professor at McGill University, who was not involved with the review.

"Because Wife cannot achieve genetic parenthood otherwise, we conclude that Wife's interest in biological procreation through the use of these pre-embryos outweighs Husband's professed interest against procreation."

This decision is a departure from court cases in other states where the courts have decided the other way.  A court in Tennessee said that unwanted parenthood would be the greater burden and ordered the embryos destroyed.  Another court in Massachusetts said it "would not enforce an agreement that would compel one donor to become a parent against his or her will."

The Inquirer reported that the Court said that "the couple's conflict could have been avoided if they had signed an agreement spelling out what to do with the embryos in case of divorce or death, or if the state legislature had passed a law addressing the issue."

Actually, this and other cases could be totally avoided if we did not allow mass manufacturing and freezing of human lives in a laboratory.  These couples are already parents.  The question is not whether parenthood is forced on them, but whether these embryos deserve a chance to finish their lives.

Continue Reading at LifeNews >>

Nadya Suleman will do anything for her octuplets, but now she admits it was a mistake to have them.

Themother of 14, who recently posed nude to earn rent money for her family, has revealed she thinks it was a bad decision to undergo fertility treatments after already having six babies.

"Was it a mistake to go back and have IVF after having six children already?" NBC News Dateline correspondent Tamron Hall asked in an interview that aired Friday night.

"Yes," Suleman said. "Absolutely. Was I in my lucid state of mind? I don't know at that point. I could rationalize myself away and I'm good at rationalizing."

Nadya, dear, you are not alone.

Continue reading at Creative Minority Report >>

Instead of turning to God to understand why, we turned to doctors and science and began working on how to fix it. We were lost and didn’t have the foundation of the Church’s teaching to help guide us.  Our primary fault was to understand that a child is a GIFT from God, not a right. We were focused on our desires, not God’s will....

After limited thought we decided to undergo the in vitro fertilization (IVF) process after doctors advised us it was the only way to conceive. Again, we just looked at the science of having children. We didn’t seek to understand the Church’s teaching on IVF, or more importantly, what consequences could develop once initiated....

The process took another turn when, following the delivery of our babies, I needed an emergency hysterectomy. This was much more significant than my husband or I could ever imagine.

During the IVF process more than two embryos were created. The hysterectomy removed my uterus, and with no uterus, there is no place for our other children to go to be carried to term. I can’t carry them, and surrogacy is not an option in the Catholic Church. With this outcome, we now have several embryos frozen in a lab with basically nowhere to go....

We pray for them everyday, but we feel helpless as parents.

A fertility clinic in Kent is under investigation after reports that staff may have lost a woman's embryos. Mrs Alison Austin-Hennessy said she and her husband Michael were informed by a consultant at the private Chaucer Hospital that their embryos had been misplaced....

Chaucer Hospital is run by BMI Healthcare and, according to the Daily Mail, an audit in March 2009 found that two embryos present in 2007 were now 'gone'. The couple said they were not informed of this, however....

'I was physically sick. For two or three days, I was ringing them up because I just expected them to be found', said Mrs Austin-Hennessy.

In an interview with People magazine, Mrs Austin-Hennessy, who is 31 years old, said that she saw a note on the file that read 'thawed', leading her to believe that the embryos may have been implanted in another woman.

'It's heartbreaking to think another woman may be carrying - or have had - our biological child', she said.

Lab desiccator used by IVF pioneer Robert Edwards to culture embryos. (Bourne Hall Clinic archives)

Should the culture system emulate, as closely as possible, the characteristics of the mother's uterus? Or should we embrace the artificiality of the culture system, and seek to optimise it accordingly? Is it best to culture embryos for a shorter duration or a longer duration before transfer? What should be the composition and temperature of the medium and surrounding air in which embryos are cultured? If freezing is involved, should eggs or embryos be frozen in the conventional (slow) way, or using the ultra-fast method of vitrification? And what are the implications of the culture system for the epigenetics of the embryo and resulting child?

After lunch attendees will learn about the long term affects of being conceived in a dish instead of a womb.  The "Growing Concern?" segment will address the epigenetic changes of the children of IVF:

Then there are the subtler and longer-term consequences of IVF. Fears that IVF babies might go on to have fertility problems have abated, not least because Louise Brown has herself had a naturally conceived and healthy baby. But epigenetics - enduring changes in the pattern of gene activity, during embryo development and beyond, that do not involve alteration of the DNA sequence - may be affected by assisted conception in ways that are as yet poorly understood. For example, genomic imprinting (which, for certain genes, prioritises the activity of the copy from one parent over the activity of the copy from the other parent) is an important epigenetic process whose disruption can lead to congenital disease (including marked learning difficulties).

Congenital disease including marked learning difficulties?  Where is the outrage that these questions are being asked AFTER millions of embryos have been created and not BEFORE.  It reminds me of a quote from Veronica Thomas, writer of the blog Children Have Rights - Say No to Repro Tech:

Scientists suspect that embryos that have developed in petri dishes are slightly different in some ways from embryos that develop in the womb, but they are still working out the specifics. They have some indications that IVF embryos are more likely to have certain genetic diseases and developmental problems. but they still need more data.... In other words, if you're an IVF child, then you are a walking human experiment. Scientists are waiting to see what will happen to you as you get older, so that they can complete their data collections on the effects of IVF on people.  Sounds really ethical, doesn't it?

The Catholic Church's stance on reproductive technologies is wildly unpopular.  I think it is for two reasons.  The first is that the U.S. Supreme Court has made up a constitutional right that is not actually in the U.S. Constitution, the "reproductive right."  It is the idea that not only do we have the ultimate right to destroy our offspring in the womb if we don't want them, but we also can create genetic offspring anyway we see fit.  Even if it means putting those offspring at greater risk of birth defects, being implanted in the wrong uterus, being destroyed by embryonic stem cell researchers or dying in the deep freeze.  The idea of "reproductive rights" has spread all over the world.

The second is that the members of our Church have not done a great job explaining why creating life outside the body, outside the martial union, is so unethical.  The Church is not against infertile couples having babies, it is simply acknowledging the fact that the best, safest and most loving place to begin our lives is in our mother's womb.  The minute life is created outside the body it becomes an object, a product of technical intervention and in many places the property of the parents.  The Church's focus is on the resulting child and their well-being and not on the desires of the parents.  William E. May said it beautifully:

 "When a child is begotten through the conjugal act, he comes to be as a gift from God, a gift crowning the spouse's mutual gift of themsleves to each other.  When a child is 'produced' it comes to be, not as a gift from God, which in truth it is, but as a product of human control."

A recent story about "selective reduction" illustrates the wisdom of the Church's teaching on technologies like IVF. Many people do not realize that abortion and IVF go hand in hand. To boost success rates, IVF practitioners implant more embryos than the couple wants babies in the hopes that at least one will take.  When more embryos than are desired implant, doctors "reduce" the pregnancy down to the desired number of fetuses.  "Reduce" is a euphemism for killing the unlucky fetuses with a shot of potassium chloride.  It used to be that doctors would only "reduce" triplets or above, but now have taken to "reducing" twins down to a single fetus.  One such story of reduction was recently in the New York Times.  Jenny discusses why she is killing one of her IVF twins:

“If I had conceived these twins naturally, I wouldn’t have reduced this pregnancy, because you feel like if there’s a natural order, then you don’t want to disturb it. But we created this child in such an artificial manner — in a test tube, choosing an egg donor, having the embryo placed in me — and somehow, making a decision about how many to carry seemed to be just another choice. The pregnancy was all so consumerish to begin with, and this became yet another thing we could control.”

Jenny has articulated Church teaching on procreation and she doesn't even know it.  There is a natural order to things and when that is bypassed and life is created in an artificial manner, it is easy to rationalize the killing of an innocent life down to a simple matter of "control."  Just like William E. May (and the Church) said it would.

Hat Tip: Jivin J

I have been hearing rumblings lately how having children is a right and how IVF discriminates against poor couples who can't afford it.  Some think that IVF should be covered by insurance or paid for with taxpayer dollars like in England.  In the debate, I came across this comment that was so wise and really gets to the heart of the matter:

There are options for CPS fostering to adoption of children that are much less expensive. It is by no means an easy road, but no adoption is, and IVF is a roller coaster at best. I think more couples struggling to pay for fertility treatments should consider what they want most, a child or a pregnancy. My best friend and her husband, who could've afforded IVF or private adoption, decided instead to open their hearts to a brother and sister in the child protection system and have since adopted those two precious kids that God made for them, even if not from them. It took her a long time to realize that she wanted to be a parent more than she needed to carry a child...

I think that is the problem with our society's view of IVF, that somehow to be a real parent you have to carry a genetically related child.  I have called this genetic vanity and it is a problem.

Instead of spending tens of thousands of dollars, creating life in dish to be barcoded and RFID tagged and then left in the deep freeze, maybe infertile couples should instead be asking themselves if what they really want is a child or a pregnancy. Is their need to be a parent or to carry a genetically related child?

What?  How can that be?  Abortion is the safety net for IVF?  It is according to one fertility doctor who admits that IVF doctors will implant more embryos than is recommended at the patient's request.  And when too many implant, then the back-up plan is "fetal reduction." Fetal reduction is code for abortion where one or more of the multiples is aborted to make the pregnancy safer for mom and remaining siblings.  From the LA Times, Dr. Steinberg admits:

But Steinberg, who has been practicing for 35 years and treats 200 to 480 patients annually, said many of his patients want to become pregnant with multiple babies in order to have large families....

"Fetal reduction remains as our safety net with in vitro fertilization," Steinberg said.

IVF has become human manufacturing to specifications.  Make as many embryos as possible, implant more than one woman could safely carry in one pregnancy and when things work too well, just get rid of the extras. 

The total disregard for human life, both of the mother and the children, is staggering.

This is exactly the reason countries like Italy and Germany have laws that prohibit fertilizing more than three eggs at a time and require that any resulting embryos be implanted.  Belgium only allows at single embryo be implanted in women under 36.  And the UK and Canada, women under 40 are limited to 2 embryos.

Interestingly enough, Sweden has probably the most strict regulations on IVF.  Single women are not allowed to get IVF in Sweden.  A couple has to be married or a in stable relationship for over 2 years.  Using donor eggs is prohibited and so is surrogacy.

It is time the United States caught a clue and realize that regulating the fertility industry is not about infringing on "reproductive rights."  It is about safety.  We continue to allow doctors to use vulnerable women and the children that result from IVF as guinea pigs.  Meanwhile stock piles of forgotten and abandoned embryos continue to mount, left in the deep freeze or given to researchers to destroy for parts.