Complementary therapy hampers IVF

Herbal medicines might interact with IVF drugs

Women using alternative therapies to boost their chance of getting pregnant may actually be doing the reverse, say UK researchers.

They found women who used complementary therapies while undergoing IVF were 30% less likely to fall pregnant than those who used IVF alone.

The Cardiff University team believe herbal remedies could possibly interfere with IVF drugs.

But experts at a fertility conference in Lyon said stress was probably key.

Indeed, the women who turned to complementary and alternative medicine (CAM) had been trying fertility treatments for longer and reported being more stressed by their fertility problems than the other women in the study.

Medical profiles

She examined the psychological and medical profiles of 818 women at the start of their IVF treatment and which of them went on to use CAM in the subsequent 12 months.

Overall, 261 or 32% of the women used some form of CAM and usually more than one type.

Nearly half of these had used reflexology and over a third had used nutritional supplements.

Women in the CAM group had more attempts at IVF - three compared to two attempts in the non-CAM group, on average - but were less likely to become pregnant.

Lead researcher Dr Jacky Boivin said repeated failure with fertility treatment might prompt women to use CAMs.

"But it may be that complementary therapies diminish the effectiveness of medical interventions.

"For example, it could be that there are interactions between herbal medicines and fertility medicines.

"Perhaps women should hold off until they have tried conventional fertility treatments."

Interaction

Alison Denham, of the National Institute of Medical Herbalists, said: "It is possible that herbs, St John's wort, being the significant one, could interact with IVF drug treatments.

"Herbal practitioners would be aware of this possibility and prescribe accordingly."

She said non-medicine based CAM could not interact with IVF drugs and that there was a range of research supporting improvements in diet as useful in infertility.

But Edzard Ernst, professor of complimentary medicine at Exeter University, said: "The most likely explanation is that those women who are prone to stress and have more health problems are more likely to try CAM.

"So CAM could only be a marker and not the cause of stress and lower success rates."

Mr Michael Dooley, consultant gynaecologist at the Poundbury Clinic in the UK, said: "It is difficult to draw conclusions from this study because it is not comparing like with like.

"It's well recognised that some CAMs can reduce stress. And stress can have an impact on fertility."

Many 'still ignorant about HIV'

There is still widespread ignorance about HIV, particularly among young people, research has suggested.

A survey by the HIV charity Terrence Higgins Trust found more than 20% of people aged 18 to 24 mistakenly thought there was a cure for HIV.

Among the same age group almost a quarter believed condoms have holes in them which let HIV through.

And more than one in ten young people thought the virus could be passed through kissing.

This is only a theoretical risk, and possible only if both parties have open sores, cuts or bleeding gums which bleed into each other. There has only been one suspected case of HIV being passed on in this way.

The poll of 1,000 adults was carried out to mark 25 years since the death of Terry Higgins, whose battle with Aids inspired friends and colleagues to set up the charity.

The results showed that ignorance about the virus were not confined to the younger age group.

Across all age groups, 28% of people either thought that condoms had holes in which let HIV through, or said they did not know.

Twelve percent thought that sharing cutlery carried a risk of HIV transmission, and 10% thought you can be infected through sweat.

Only one in three people who were surveyed said they thought they had received good sex education at school.

Much confusion

Nick Partridge, chief executive of Terrence Higgins Trust, said: "It's frightening that 25 years after Terry Higgins' death, this level of confusion exists.

"The lack of good sex education means many young people are leaving school ignorant about HIV and safer sex.

"HIV is now the fastest growing serious health condition in the UK, and there is no cure. It's time to get our facts straight."

Terry Higgins was among the first people to die from an Aids-related illness in the UK.

Since his death in 1982, more than 17,000 others have died from Aids-related diseases and there are now more than 70,000 people living with HIV in the UK.

More people than ever before were newly diagnosed with HIV in 2006.

Groups most at risk of HIV in the UK continue to be gay men and the African community.

Anti-retroviral drugs can keep HIV in check for most people who take them.

But there is growing concern that the drugs will become increasingly ineffective, as HIV - which can change its structure with astonishing speed - evolves ways to combat their action.

Cloned sperm created in the lab

Cloning sperm could enable men with very low sperm counts to become fathers, say US scientists.

By injecting a single healthy mouse sperm into a mouse egg from which the genetic material had been removed they were able to make new sperm.

With some refining, the Cornell University team believes the technique could be used for infertile couples.

But experts at a fertility conference in Lyon raised safety concerns as mice made from cloned sperm were abnormal.

Professor Takumi Takeuchi and colleagues said four offspring had grown into "normal adults".

They conceded that much more work was needed to understand why some of the mouse embryos were abnormal and why others failed to develop.

But they said it had the potential to be a viable fertility treatment.

Common problem

Fertility problems are extremely common, affecting one in seven couples attempting a first pregnancy. In about 40% of these cases, a problem with male fertility is a factor.

Where the man in a couple has problems making enough sperm, doctors are confronted with retrieving a single viable sperm to inject into an egg.

Professor Takeuchi said: "If you only have one healthy sperm you would be reluctant to use it for anything but fertilisation.

"But with this technique it should be possible to create enough sperm to be sure that the embryo which is implanted is healthy."

But Professor Keith Campbell, an expert on artificial gametes at the University of Nottingham in the UK, had reservations about the technology.

"I do not think it has got utility at the moment, apart from in the research lab. Work like this is still in its infancy and we have a lot to learn."

He said it would be important to look at future generations of mice born from the clone-made rodents because there might be abnormalities, such as a propensity to heart disease or diabetes, that could be passed down to offspring.

Proposed new UK laws would ban the use of artificially created sperm, and eggs, in fertility treatments.

Girl could give birth to sister

A Canadian mother has frozen her eggs for use by her seven-year-old daughter, who cannot have children naturally.

Should the girl opt to use the eggs and gain regulatory approval, she would effectively have a baby that was her half-brother or sister.

Critics said the work, presented at a fertility conference in Lyon, was deeply concerning.

But the doctors from the McGill Reproductive Center, Montreal, called the donation an act of motherly love.

Also, the girl and any future partner would have a choice as to whether to use the eggs or not, they said.

The girl, Flavie Boivin, cannot have children naturally because of a chromosomal condition called Turner's syndrome.

Desperate to help, mum Melanie, who is 35 and a lawyer, investigated whether she could donate her own eggs.

After much research, she came across Professor Seang Lin Tan's team at McGill who run an egg freezing program for cancer patients and those who want to delay childbearing.

Melanie said she discussed the decision with her partner and Flavie's father, Martin Cote, also 35 and a financial analyst.

Emotional impact

"We were concerned about the ethical questions - would I look at the child as my grandchild or as my own? We were also concerned about the financial impact, the physical impact on me and the emotional impact on the family."

After a year they decided to go ahead.

"What made us sure was the fact that I was there to help my daughter. If I could do anything in my power to help her I had to do it and because of my age I had to do it now.

"I told myself if she had needed another organ like a kidney I would volunteer without any hesitation and it is the same kind of thought process for this."

Melanie said her daughter would be the real mother as she would be caring for the child.

"I do not want to oblige her to use the eggs; I want to give her the option."

Professor Tan said they had asked for the advice of an independent ethics committee.

"The ethic committee agreed to it because the mother giving to a daughter is out of love and it is up to the daughter and partner in future years to decide whether to use the eggs or not.

"And ethical considerations change with time. Who knows what the ethics will be in 20 years from now."

Identity problems

Professor Tan said this was the first case of mother-to-daughter egg donation. There have been cases of donation from sister to sister.

Josephine Quintavalle, of Comment on Reproductive Ethics, said: "One can understand the sadness of the mother in question but the proposed donation of eggs to be stored for her seven-year-old daughter with Turner Syndrome is not something to be welcomed.

"The psychological welfare of the baby itself has to be the principal concern. Such a baby would be a sibling of the birth mother at the same time as the direct genetic offspring of the grandmother donor.

"In psychiatry we are hearing more and more of children suffering from identity problems, and specifically a condition called 'genealogical bewilderment'. Could it possibly get more bewildering than this?"

First baby from lab-matured egg

The first baby created from an egg matured in the lab, frozen, thawed and then fertilised, has been born.

Until now it was not known whether eggs obtained in this way could survive thawing to be fertilised.

The advance spares women from taking risky fertility drugs that can cause a rare, yet deadly condition - ovarian hyperstimulation syndrome (OHSS).

Canadian researchers told a fertility conference in Lyon three others are expecting babies by the same process.

The findings hold particular hope for patients with cancer-related fertility problems.

Chemotherapy can cause infertility and, therefore, some women with cancer opt to have their eggs collected and frozen before they start their cancer treatment.

But not all women will want or be able to delay having chemotherapy to undergo ovarian stimulation.

Certain tumours, including some breast cancers, can grow if the woman takes drugs to stimulate the ovaries, for example.

Early stages

Dr Hannal Holzer and colleagues at the McGill Reproductive Center, Montreal, cautioned that their technique - in vitro maturation or IVM - had not yet been tried on women with cancer.

The women they studied had polycystic ovarian syndrome (PCOS) - a condition where the ovaries are covered in cysts which can impair fertility and which is linked with an increased risk of OHSS.

Of 20 women, four achieved pregnancy with the technique.

Dr Holzer said: "Until now, it was not known whether oocytes collected from unstimulated ovaries, matured in vitro and then vitrified, could survive thawing, be fertilised successfully and result in a viable pregnancy after embryo transfer.

"We have demonstrated for the first time that it is possible to do this and, so far, we have achieved four successful pregnancies, one of which has resulted in a live birth."

He warned the research was still in its early stages.

Moderate or severe ovarian hyperstimulation syndrome can occur in 3-8% of IVF cycles.

Expand choices

Professor Robin Lovell-Badge, of the Medical Research Council's National Institute For Medical Research, said: "Each step in this work had been achieved before, but this is the first time they have been successfully strung together.

"It is important as it will expand the choices available to women with diseases of the ovary or cancer and the clinicians treating them."

Dr Laurence Shaw, spokesman for the British Fertility Society, said: "These pregnancies are an exciting step. However, the pregnancy rate is very low and therefore large numbers of eggs would be needed."

He stressed that it was a treatment suitable for people with fertility problems linked to conditions such as PCOS or cancer, and not for women who merely want to delay having a family.

IVF hope for child cancer cases

Israeli scientists say that they have extracted and matured eggs from girls as young as five to freeze for possible fertility treatment in the future.

The team said that the technique could give child cancer sufferers left infertile by chemotherapy treatment a shot at parenthood later in life.

The team took eggs from a group of girls between the ages of five and 10 who had cancer.

They artificially matured the eggs to make them viable and froze them.

Experts had previously thought the eggs of pre-pubescent girls could not be used in this way.

Dr Ariel Revel, from Hadassah University Hospital in Jerusalem, is to present the team's findings at a fertility conference in Lyon, France, this week.

"No eggs have yet been thawed, so we do not know whether pregnancies will result," he said in a statement.

"But we are encouraged by our results so far, particularly the young ages of the patients from whom we have been able to collect eggs."

The aggressive chemotherapy used to treat many childhood cancers can leave patients sterile.

The new technique could give girls an option they would otherwise not have, the team said.

England smoking ban takes effect

Smokers across England have sparked up at work and in the pub for the last time as the ban on smoking in enclosed public places begins.

The new law, which came into effect at 0600 BST, is intended to cut deaths from second-hand smoke.

Scotland, Wales and Northern Ireland already have similar bans in place.

Many venues held farewell events for the final night of smoking on Saturday, while local authorities are preparing to enforce the ban.

Doctors estimate second-hand smoke kills more than 600 people a year.

The government also hopes it will help smokers to quit, and discourage children from taking up the habit.

Fines

The new Health Secretary, Alan Johnson, welcomed the ban saying that tackling the causes of illnesses saved lives.

"A smoke-free country will improve the health of thousands of people, reduce the temptation to smoke and encourage smokers to quit," he added.

England's chief medical officer Sir Liam Donaldson said the ban was a "momentous move" and would prevent the deaths of both smokers and non-smokers.

"We are removing from the air at a stroke 50 cancer causing chemicals, and that's bound to be good news for the exposure to risk," he said.

From Sunday anyone lighting up illegally could be fined £50 - reduced to £30 if it is paid within 15 days.

The figure rises to £200 if an individual is prosecuted and convicted by a court.

Businesses failing to comply with the ban could be hit with fines of up to £2,500.

The ban has prompted protests by smokers and those concerned about what they see as the "nanny state".

A legal challenge to the ban has been launched at the High Court by Freedom2Choose, which says the change in the law contravenes the European Convention on Human Rights.

Smokers from the group defied the ban The Dog Inn in Ewys Harold, near Hereford.

Landlord Tony Blows said he was prepared to go to court.

Mr Blows said: "I'm doing it for the simple reason that this is my home. My wife and I work 200 hours a week in this pub. It's private property and there's no way they can stop us doing it.

"Pubs have been smoking for goodness knows how long and you just can't do that. It's been brought in on the back of a pack of lies."

Decline in sales

Others are worried that the ban will mean the demise of the traditional pub and other social haunts such as middle-eastern style shisha cafes.

Market researchers Nielsen estimate beer sales in England and Wales could drop by 200 million pints each year because of the ban.

However, a survey by the Campaign for Real Ale suggested England's 6.2 million regular drinkers are likely to go out to pubs and bars more often after the ban.

Its study also found that 840,000 people who currently do not go to the pub said they would do so after smoking was made illegal.

Mark Hastings, communications director of the British Beer and Pub Association, said that although the ban may lead to a small decline in beer sales, pubs would also see an increase in the sale of food.