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First British women to have £1,000 'no-frills' IVF: Budget procedure

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Procedure inspired by Alka-Seltzer to be available within weeks

  • Newly developed method economizes on expensive drugs and incubators
  • Instead it uses cheap test-tube set and reaction inspired by hangover pills
  • However, expert warns that the new procedure may not work for all women
By FIONA MACRAE  30 January 2014 A ‘no-frills’ IVF treatment costing under £1,000 should be available to British women within weeks. The budget procedure, which was developed last year, economises on expensive drugs and incubators. Instead, it uses a cheap test-tube set and a chemical reaction inspired by Alka-Seltzer hangover tablets.

Despite its low-tech approach, a pilot study showed the treatment to be at least as effective as the conventional equivalent, which costs up  to £15,000. Dr Geeta Nargund, of the Walking Egg foundation, who is bringing the procedure to Britain, believes it will allow the NHS to pay for more  IVF treatments. Thousands of women are denied IVF each year because health trusts cannot afford the cost, leaving patients to choose between finding the thousands of pounds needed to go private or remain childless.

The cheap new technique has been tested in Belgium, where a third of the women involved became pregnant, resulting in 16 births. Dr Nargund’s London clinic, Create, will now treat 50 women aged 37 or younger, comparing their progress with 50 given normal IVF. If the study is a success, the technique could be generally available by later this year. Although the no-frills women will be charged under £1,000, and Dr Nargund insists this will be the cost of the procedure, other doctors have warned that the final commercial price may be higher. The huge savings are possible because the new treatment does without an array of expensive equipment. An embryo must be grown in a nutrient mixture that is neither too acidic nor too alkaline. This is achieved by pumping expensive, medical-grade carbon dioxide into an incubator, which itself must be in a room kept sterile with purified air. But Professor Jonathan Van Blerkom, of the University of Colorado, showed it was possible to provide the gas by dissolving an Alka-Seltzer tablet in water. He then moved on to using baking soda mixed with citric acid.

 

Inspiration: Professor Jonathan Van Blerkom showed it was possible to make the gas needed for IVF by dissolving Alka-Seltzer tablets in water rather than an incubator, he used two rubber-stoppered test-tubes costing 7p and connected by a plastic tube. The gas is made in the first and travels up the tube to the second. The eggs and sperm are injected into the second tube, where, if all goes well, at least one egg is fertilised. The stoppers keep everything airtight, removing the need for purified air, and the embryos grow inside the tube. After three to five days, they are ready for transfer to the womb.
The process uses fewer drugs at lower doses, which cuts costs and should lead to fewer, higher quality embryos, meaning the costs of selecting screening for genetic faults and freezing spare embryos should be reduced. There may also be less need for expensive sperm injections. Professor Van Blerkom, whose main aim was to help couples in the developing world, said: ‘The embryos don’t know if they are living in an expensive incubator and a lab with purified air or in a little tube. They don’t care. There’s nothing magical.’
Dr Nargund, whose Walking Egg Foundation is planning to launch the kit in the developing world, said: ‘I see couples in my NHS work who are in tears when they learn there is no funding and they have no money to pay for private treatment. ‘We have an obligation to reduce costs as much as we can and increase accessibility.’ In an editorial in the journal Reproductive Biomedicine Online, Martin Johnson, emeritus professor of reproductive sciences at Cambridge University, described the results so far as ‘encouragingly impressive’. However, he warned against raising false hope, saying that the technique won’t be suitable for all couples.
This will make it difficult to lower costs in western clinics, because they will still need to have the staff, equipment and expertise to offer conventional treatments. Dr Allan Pacey, a Sheffield University fertility expert, said: ‘We should be realistic about how and when it might change the face of IVF in high-resource countries like the UK. This may never happen but it is laudable to try.’ See original story here
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More Women Successfully Using Egg Donors

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More U.S. women are attempting to have children using eggs donated by other women and taking home healthy babies as a result, a new study shows. Fertility clinics reported 18,306 procedures using fresh or frozen donated eggs in 2010, up from 10,801 in 2000, according to the study published online by the Journal of the American Medical Association, or JAMA, and presented Thursday in Boston at the annual meeting of the American Society for Reproductive Medicine and the International Federation of Fertility Societies. Nearly one-quarter of the women who used donor eggs in 2010 ended up with what doctors consider an optimum outcome: a single baby, born after at least 37 weeks of pregnancy, weighing at least 5.5 pounds, the study found. That's up from 18.5% in 2000. "There's still room for improvement," but the trends are encouraging for couples increasingly looking for ways to extend child-bearing years, says lead author Jennifer Kawwass, a fellow in reproductive endocrinology and infertility at the Emory University School of Medicine, Atlanta.

Donor eggs often are used by women who are older than 35 and having trouble becoming pregnant because their own viable eggs are in short supply. However, the study shows that traditional in vitro fertilization (IVF) procedures – in which women use their own eggs, with sperm from their partner or a donor – remain much more common, comprising 89% of procedures in 2010. Older women who use their own eggs are less likely to end up with a baby, but "for most people, the desire to have a child that is genetically from both parents is very strong," says Evan Myers, a professor of obstetrics and gynecology at Duke University School of Medicine, Durham, N.C. "Donor eggs are still often seen as a last resort."

In an editorial accompanying the study, Myers says the fact that poor birth outcomes did not increase as the ages of egg recipients increased suggests that using donor eggs from younger women may help prevent pregnancy complications usually associated with a woman's age – something that should be further studied. Recipients had an average of age of 41 and donors an average age of 28 in 2010, about the same as in 2000, the study found. The study did not look at health effects on donors, who typically are paid $5,000 to $10,000 for undergoing a month of fertility drug treatments and an egg retrieval procedure. Myers says more study is needed, especially to learn how many donors suffer a complication known as ovarian hyperstimulation syndrome – which can cause rapid weight gain, abdominal pain and other symptoms.

The study did have data on one important safety consideration for recipients and their babies: the number of embryos placed in each prospective mother's womb. Since risks increase with multiple fetuses, the reproductive medicine society recommends that patients and doctors use no more than two embryos and consider using a single embryo when the donor is under age 35. In 2000, single embryos were used less than 1% of the time; in 2010, they were used in 14.5% of cases, the study found.

The fact that most patients still got more than one embryo largely reflects patient preferences, says William Schlaff, chief of obstetrics and gynecology at Jefferson University Hospitals, Philadelphia. Schlaff, who was not involved in the study, says many patients are willing to take the risk of having twins to raise their chances of having at least one baby and to decrease costs. Some, he says, are eager for twins: "They come in saying 'We only want to do this once.' " About 56% of couples who used fresh eggs in 2010 took home babies and two-thirds of those couples had just one baby, Kawwass says. About one third had twins and fewer than 1% had triplets. Two-thirds of the single babies, 25% of the twins and just 1% of triplets were born after 37 weeks and at a healthy weight, she says. The study did not look at similar outcomes for frozen eggs. Data for the study came from 443 clinics reporting to a registry maintained by the federal Centers for Disease Control and Prevention. The clinics represent 93% of such facilities in the United States This story is from usatoday.com: http://www.usatoday.com/story/news/nation/2013/10/17/donor-egg-pregnancy/2996959/

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