The current guidelines in the UK state that women up to the age of 39 years should be offered up to three attempts at IVF at the state’s cost (ie public funding). That however, has been seen to discriminate against women above 40 and there has been intense lobbying over the years to allow older women access to this free treatment.

Well, at last the pleas have been noted and acted upon. The NICE guidelines, which are drafted by the Govt, and which all healthcare providers are meant to abide by, now has upwardly revised the age criteria for ivf to 42 years. So in theory, all women under 42 years can avail themselves of free ivf on the Govt’s account. In reality however, there are funding restrictions on the healthcare system, so it remains to be seen how many of the over 40s will actually benefit from this move. My guess is that unfortunately, in this time of recession and economic downturn, there is simply not going to be enough money in the NHS (UKs National Healthcare Service) to fund this. As it is, women below 40 are complaining that they are not getting their ivf entitlement.

Sadly even in the Government sector, money plays a part in whether you have a chance at parenthood.

Male fertility problems generally stem from their sperm being unable to activate the female’s egg. Even though the sperm fuses with the egg, nothing happens and conceiving a child doesn’t occur. And even during ICSI, when the sperm has been injected into the egg, a good embryo does not develop. This is one reason why sometimes eggs do not fertilise.

A study performed by scientists at Cardiff University in Wales, has demonstrated that one form of male infertility could be caused by the male sperm lacking a specific protein. Their results have been published in the journal Fertility and Sterility, and could lead to the eventual treatment of this form of male infertility.

The protein known as PLC-zeta is required to activate the female’s egg when it combines with the sperm. By injecting the egg with the protein that is missing, it can launch the embryo development, leading to a dramatic increase in the chances of a pregnancy. Scientists at the University are looking to produce the missing protein and use it to stimulate egg activation, which could offer couples who are undergoing IVF and ICSI greater pregnancy rates.

It could be some time before the protein is fully developed and used in clinical treatments for patients with poor sperm but it could ultimately improve the treatment of male infertility, and the chances of having a baby.

There has always been a worry that fertility treatment may slightly increase the chance of a birth defect.

A new study published in the Journal of Obstetrics and Gynaecology suggests that the prevalence of birth defects in births conceived with IVF and ICSI may be declining. The research which was performed in Australia, analysed data over a decade and discovered that birth defects reduced over the ten year period.

The study looked at 207,000 births, including 1,328 babies conceived through IVF (In Vitro Fertilization) and 633 babies by ICSI (Intracytoplasmic sperm injection), from 1994 to 2002.

It is unclear why babies born through ART are slightly more prone to have a birth defect to begin with, but the study shows they are definitely becoming less frequent. Michele Hansen, the lead author of the study, suggested that improvements to laboratory practice, changes to medications and a decrease in the number of embryos transfered may have all had a positive impact on the baby’s health.

While recent studies have suggested that IVF or ICSI is linked with approximately 4% chance of a birth defect, this study shows that the defects are decreasing and will hopefully continue to do so. Natural conception has a slightly lower chance (3%) of birth defect, a difference of only 1% compared to IVF.

There is in fact, a much greater risk of birth defects and miscarriage from parental smoking, alcohol consumption and other lifestyle factors.

ivf and obesity

(Image: Michelle Meiklejohn at freedigitalphotos.net)

New research published in the online journal Human Reproduction, has suggested that the reason obese women have problems becoming pregnant through IVF or ICSI, could be due to the reduced quality of their eggs.

For an egg to fertilise correctly and to support embryo development in a healthy way, it needs have a single egg structure known as a ‘spindle’, and attached to this is one set of chromosomes which are organised correctly. The research which was undertaken at Brigham and Women’s Hospital in Boston, found that severely obese women suffer greater chance of having eggs that have jumbled chromosomes, and multiple spindles, which can lead to conceiving problems.

276 mature eggs were studied, 105 from obese women and 171 from women of a normal weight. Almost 60% of the eggs from obese women had two spindles, and 30% had disorganised chromosomes. The findings for normal weight women were significantly lower.

The study demonstrated how weight and body mass can significantly alter egg quality and conceiving chances. It interestingly comes shortly after a decision by several IVF clinics in the UK in 2012 to deny treatment to women wanting to undergo IVF, if they had a BMI (Body Mass Index) of over 30. Their decision was based on evidence that being significantly overweight can reduce fertility.

Cola reduces sperm counts

The effect of caffeine on sperm count and quality remains hotly debated. Some studies have shown no difference but again there are others that suggest some effect of excess caffeine intake.

In coming to a conclusion, it is good to look at studies which study large number of patients. The larger the numbers of patients, the more likely the results are to be correct. So when the recent study in the American Journal of Epidemiology entitled “Caffeine intake and semen quality in a population of 2,554 young Danish men” concluded that heavy intake of cola depressed sperm counts by approximately 30%, we have to look seriously at the results due to the large number of men followed up over an extended period of time (four years). Whether this is due to the high intake of caffeine or to some other ingredient in cola is not known.

There was no effect on mild to moderate drinkers of cola, so for those of us who enjoy an occassional cola drink, there seems to be little or no risk. However, like  all good things in life, moderation is the key. Apart from cola, other sources of caffiene include tea, coffee and chocolate.