|
Written by Randy Morris
|
|
Saturday, 03 September 2005 |
Stress does not reduce the success of IVF
During IVF treatment, patients frequently ask about the relationship between psychological stress and IVF success. They often express concern that their own stress might have a negative influence on the outcome of IVF. Furthermore, support groups have advanced the notion that stress reduction can result in greater IVF success. Groups offering stress reduction services have been actively promoting themselves by citing the results of small scale studies pointing to the benefit of their own services towards improving the success of IVF (at a price of course).
A 2005 study of 166 infertile women looked at whether stress affected the success of IVF. All of the women in this study were treated using a standard IVF treatment regimen. The women answered extensive questionnaires concerning psychological factors. The first questionnaire was filled in one month before the onset of IVF treatment and the second questionnaire was completed one hour before the egg retrieval.
The questionnaires included the following:
General psychological well-being was measured by the Psychological General Well-Being (PGWB) index. The PGWB contains 22 items with six response alternatives. The higher the value measured on the index, the better the well-being.
In addition to a total score for the index, there are sub-scores for anxiety, depressed mood, positive well-being, self-control, general health and vitality. In addition to the well-evaluated PGWB, psychological effects of infertility were measured by 14 items (guilt, success, anger, contentment, frustration, happiness, isolation, confidence, anxiety, satisfaction, depression, powerlessness, competence and control). Each item was graded from 1 to 5. Low figures indicate well-being.
The PGWB results did not differ between pregnant and non-pregnant women. In general, the PGWB values were comparable with reference values reflecting that the women starting IVF treatment were in good psychological health. When analyzing each of the 14 items in the questionnaire concerning the psychological effects of infertility, no differences were found between women who got pregnant and those who did not.
Even when the analysis was restricted to compare those women with the most abnormal scores, there was still no difference seen between those women who became pregnant with IVF and those who did not.
The results of this study do not indicate any relationship between perceived psychological stress or perceived psychological well-being before or during the first IVF treatment and IVF success. These results can be regarded as reassuring and can help to decrease the stress experienced by patients.
|
|
|
Written by Administrator
|
|
Saturday, 16 July 2005 |
PCOS Treatment with Zocor
Zocor-simvastatin is a medication typically used to treat high cholesterol. Recent evidence suggests that Zocor may be a useful treatment for PCOS – polycystic ovary syndrome.
PCOS Study
A recent study presented at the annual meeting of the Society for Gynecologic Investigation is the first to look at the effects of these medications in women with PCOS. Women with PCOS are often found to have high cholesterol and triglycerides.
The PCOS patients in the study were first placed on birth control pills. This was necessary because Zocor and related medications, known collectively as statins, are contraindicated in pregnancy. One half of the PCOS patients also received Zocor.
PCOS Study Results
A comparison of the hormone levels in these patients before treatment and again after 12 weeks showed was quite impressive. Testosterone is a hormone that is commonly elevated in PCOS. Testosterone belongs to a class of hormones known as androgens. Androgens are what many people think of as male type hormones. In women, when testosterone levels are elevated, such as in PCOS patients, they can have problems with unwanted hair growth, acne and hair loss. In this study, testosterone fell by an average of 41% in the group that received the combined birth control and Zocor. By contrast, in the birth control alone group, levels fell by only 14%.
Another androgen that can be elevated in PCOS patients is dehydroepiandrosterone sulfate (DHEAS). DHEAS elevations in PCOS patients have been treated with steroids and is associated with numerous side effects. DHEAS levels fell 26% in the combined birth control and Zocor patients and 28% in the birth control alone group.
PCOS patients can also show abnormal patterns in pituitary hormones luteinizing hormone (LH) and follicle stimulating hormone (FSH). In most healthy women, their levels of FSH and LH are about the same. PCOS patients, on the other hand, will sometimes have elevated LH levels and consequently an elevated LH to FSH ratio. In this study of PCOS patients, the group that was receiving birth control pills alone had a reduction of LH of about 9%. The group that also took Zocor had a 43% in the LH levels. As a result, the LH:FSH ratio declined significantly in the combined group (44%) but fell by only 12% in the birth control group.
As expected, the Zocor group showed improved cholesterol levels. Total cholesterol was 10% lower with the addition of Zocor. Using birth control pills alone, the total cholesterol rose by 8%. Low-density lipoprotein (LDL) cholesterol dropped by 24% in the Zocor patients, but stayed the same in the birth control patients. Zocor did not have a beneficial effect on triglycerides. This makes sense since triglyceride levels can be elevated due to insulin resistance in PCOS patients and Zocor did nothing to improve insulin resistance.
Conclusions
Based on the results of this study, women with PCOS, especially those with high cholesterol should be offered treatment with statins. PCOS patients are known to bat greater risk for developing heart disease. It is important to try to decrease as many risk factors as possible.
However, women who are attempting pregnancy should not take statins. |
|
|
Written by Administrator
|
|
Friday, 15 July 2005 |
|
Bed rest after in vitro fertilization (IVF) not necessary
I hear it all the time. My patients correspond with in vitro fertilization (IVF) patients at another program. "Their doctor says they have to go on bed rest after the embryo transfer or it won't work." I have always thought this was baloney. Now more proof that it is baloney.
A recent study of 378 women who were undergoing in vitro fertilization (IVF) were randomly assigned to rest for either 1 or 24 hours following an in vitro fertilization (IVF) embryo transfer. The 1-hour rest group had a rate of 21.5 percent, whereas the 24-hour rest group had a rate of 18.2 percent. Actually, the implantation rate per embryo in the 1-hour rest group was 14.4 percent, which was higher than the 9 percent rate seen in the 24-hour rest group.
Previous studies have all reached the same conclusion. Resting after an in vitro fertilization (IVF) embryo transfer does nothing to improve the pregnancy rate. This makes good sense since women who achieve pregnancy spontaneously do not rest so why would it be necessary after in in vitro fertilization (IVF).
Also, since implantation does not occur until day 7 or 8, a day or two of rest after a day 3 embryo transfer would seem to be ridiculous. Now I couldn't argue if someone was recommending five days of rest, that study has never been done but programs that stick by this do not recommend rest for that long.
Bottom line? Rest if you want to but if you don't it won't hurt your chances.
|
|
|
Written by Administrator
|
|
Friday, 15 July 2005 |
Health risks of children born from in vitro fertilization (IVF)?
Article last published/updated 01/06/2005
A study conducted by Kathy Hudson, PhD., who is the director of the Genetics and Public Policy Center at John Hopkins University, reviewed the available medical literature (169 studies) on children conceived through in vitro fertilization (IVF).
The results are generally reassuring. In vitro fertilization (IVF) babies do not have higher rates of cancer, malformations, psychological or developmental delays.
Singleton in vitro fertilization (IVF) babies ARE at increased risk for premature birth, low birth rate and death in the first few weeks of life.
Twin in vitro fertilization (IVF) babies are NOT at any higher risk for these problems than naturally conceived twins. I should mention that twins are at higher risk for these complications compared to singletons and twins are more likely to occur as a result of multiple embryo transfer but in vitro fertilization (IVF) itself does not appear to increase the risk.
There were two rare genetic disorders, Beckwith-Wiedemann syndrome and Angelman's syndrome that the study made a special comment about. In the case of these two problems, the study found evidence that was "suggestive but not sufficient" to indicate that in vitro fertilization (IVF) may increase the risks of these problems.
The problem is that these syndromes are both very rare to start with. That makes it very difficult to determine then whether in vitro fertilization (IVF) has any adverse effect. Further study is needed in a much larger study to determine whether there is a risk.
There has been a lot of information in the media about the possible risks to the babies born through in vitro fertilization (IVF). This study, which is the largest study of its kind, I think is very reassuring.
There has been some noise in the field about establishing an in vitro fertilization (IVF) registry for children born through in vitro fertilization (IVF) I think it is probably a good idea and may be the only way to answer some of the questions we have about in vitro fertilization (IVF). Opponents say that it violates the privacy of the children in the registry and places a "stigma" on them. I can't argue that but still feel that benefits outweigh the disadvantages. |
|
|
Written by Administrator
|
|
Friday, 15 July 2005 |
Intracytoplasmic sperm injection - ICSI - does not increase miscarriage risk
Last published / updated 01/07/2005
A study out of Italy published in the December issue of Fertility and Sterility compared the rate of pregnancy loss - miscarriage - between patients who underwent standard in vitro fertilization - IVF and those who had intracytoplasmic sperm injection - ICSI .
The study looked at the number of fetuses identified on ultrasound in the second trimester compared to the number identified in the early first trimester.
The conclusion was that intracytoplasmic sperm injection - ICSI does not increase the risk that a pregnancy will miscarry.
I think this adds to the growing body of evidence that intracytoplasmic sperm injection - ICSI is as safe as in vitro fertilization - IVF . However, the design of the study does not allow us to determine whether very early miscarriages (those that might occur before a pregnancy can be seen on ultrasound) occur at the same rate. These are referred to as chemical pregnancies and are identified by a positive blood or urine pregnancy test. |
|
| | << Start < Prev 1 2 Next > End >>
| | Results 46 - 70 of 70 |
|
IVF, PGD and Infertility News and Information 
