Tuesday, May 18, 2010

Soft IVF: A safer, cheaper way to artificially conceive


I just read an article about IVF methods I've never heard of before: soft IVF and natural-cycle IVF.  Not only do they cost less than normal IVF, but unlike standard IVF, they don't force the body into menopause and have no health risks.  Read the full article:
 The Telegraph

Here are some excerpts from the article:

"I was told I had fewer eggs than expected for a woman of my age and warned the quality could be poor," says Marina. "My fertility was more like that of a woman of 40, and my chances of conceiving naturally were around 10 per cent.
The couple were told that IVF offered the best chances of a successful pregnancy, and Marina joined the ranks of more than 36,000 women who undertake IVF each year in Britain. Like many of these women, Marina had to undertake the treatment privately. For while the NHS offers infertile couples aged between 23 and 39 three cycles of IVF, standards of service vary across the country, with many primary care trusts offering fewer cycles.
Marina had concerns. "As a chemist, I didn't want to throw myself into IVF. I was concerned about the drugs involved." She decided to explore her options and contacted dozens of fertility clinics before coming across one that offered alternatives to conventional IVF.
Create Health Clinics in London offered two procedures that sounded promising: "soft" IVF, which uses minimal doses of drugs and "natural-cycle" IVF, in which no drugs at all are used. Compared to the average £5,000 cost of a cycle of standard IVF, soft IVF (£2,500 per cycle) and natural-cycle IVF (£1,500) were also considerably cheaper.
"Soft IVF is far less disruptive to a woman's body than the standard approach,"says Dr Geeta Nargund, consultant gynaecologist and director of Create Health Clinics. "With soft IVF, ovary-stimulating hormones are given to a woman during her natural cycle, whereas the practice with conventional IVF is to induce an artificial menopause and then kick-start an artificial cycle,"
"The drug doses are also far lower – just 30-40 per cent of those used in standard IVF. The aim is to collect around six or seven mature eggs rather than 12 to 14. As a result, there is a greatly reduced risk of ovarian hyperstimulation syndrome, a condition in which the ovaries and abdomen can swell and fill with fluid. It can lead to discomfort and nausea and, in severe cases, may prove fatal. It affects up to 2 per cent of women undergoing IVF." explains Dr Nargund.
Marina began her first soft IVF treatment in June 2006. "I was given a 10 per cent chance of success and the first two attempts failed," she says. "Each time, the fertilised egg grew into an embryo but when it was placed back in my uterus, it didn't implant in the womb lining."
Dr Nargund recommended that for her third attempt Marina try natural-cycle IVF. This procedure uses sophisticated scanning techniques to monitor blood flow and the growth of an egg within a woman's natural cycle. Just before ovulation, the egg is collected and fertilised in the laboratory. If it grows into a healthy embryo, it is placed in uterus three to five days later.
Marina's procedure was a success. "To our absolute delight, I became pregnant," she says. "My son Radha is now two-and-a-half."
...
"The ovaries of women who are nearing the end of their fertility do not respond well to fertility drugs," explains Dr Nargund. "We also know that stimulating the ovaries with higher drug doses is linked to a negative effect on egg quality. That is not what you want when your egg quality and quantity may already be low."
Indeed, scientists at the University Medical Centre in Utrecht found that using lower drug doses and collecting fewer eggs was equally, if not more, effective in producing healthy embryos. Soft IVF produced 39 per cent of healthy embryos compared to just 28 per cent in women given conventional IVF.
"It is generally thought that the more eggs the better, but what you really want is better quality eggs and embryos," says Dr Esther Baart, embryologist at the University Medical Centre in Utrecht, who carried out the study.
Bill Ledger, Professor of Obstetrics and Gynaecology at the University of Sheffield and head of the Assisted Conception Unit at the Royal Hallamshire Hospital, says that the benefits of soft IVF are so clear, he hopes it will one day replace high-dose approaches.
"At Sheffield, we've been offering soft IVF for a long time," he says. "It's more attractive to patients who are wary of higher dose drugs and we get comparable results. With the standard protocol, the woman suffers at least a two-week menopause with hot flushes, night sweats and no libido. With mild IVF, that just doesn't happen."
...
"These approaches are safer for the woman, cheaper, less disruptive and vastly reduce the risk of multiple pregnancy," she says. "It really makes sense to consider them instead of blindly using high doses of fertility drugs."

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