Treating thryoid antibodies in pregnancy
The effects of selenium in pregnancy were recently evaluated in a study performed in Italy. This study is of interest to me since we have been using selenium to reduce thryoid antibody levels in women with
recurrent miscarriage. Selenium has been found in well controlled studies to reduce thryoid antibody levels but it has neve been evaluated in a pregnant population before.
Approximately 150 pregnant with with elevated levels of one group of thyroid antibodies were split into two equal groups. One group received 200 micrograms of selenium and the other group received placebo. During pregnancy and post-partum, more women who took the placebo were more likely to show evidence of thyroid malfunction and need thyroid hormone supplementation.
The levels of
thyroid antibodies were reduced in women who took selenium.
Although this study still does not prove that selenium will reduce the risk of miscarriage in these patients, it does indicate that the antibody lowering effects are similar to that seen in non pregnant patients. It also appears to be safe during pregnancy.
IVF Children are Taller and Have Better Cholesterol Profiles
A number of studies have been performed to determine whether children conceived as a result of
IVF have any greater health risks than children conceived in other ways. Some studies indicate that
IVF children may be at greater risk for complications during pregnancy and birth defects. Other studies argue that
IVF children may be smaller at birth than other children.
A recent study conducted with New Zealand school-aged children compared 50 children conceived as a result of
IVF to 60 who were conceived naturally. The children were aged 7 to 9 at the time of the study.
The authors of this study found that 15% of the
IVF group was smaller at birth than expected for their gestational age. However...
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IVF children taller
Assisted zonae hatching - AZH - does not increase IVF Success in women with endometriosis
Assisted hatching or
AZH is a procedure occasionally used in
IVF treatment cycles. There has been great controversy regarding whether AZH increases the chances for an
IVF pregnancy. Numerous studies have been conducted over the years. Some studies have suggested that there is a higher chance for pregnancy using AZH while others showed no improvement whatsoever.
The zonae is a hard protein shell that surrounds the embryo. During
IVF cycles, the zonae can be seen under the microscope. Before an embryo can implant into the uterine lining, the embryo must break out of the zonae. This is known as hatching. It has been hypothesized that some embryos may have a more difficult time implanting because they cannot break out of the zonae. During
IVF, the process of hatching can be assisted by either thinning the zonae or making a small gap.
Recently, a study was performed to determine whether women with endometriosis who underwent treatment with IVF would have a better chance to conceive with AZH than women who did not have AZH.
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IVF in Endometriosis Study
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 recent 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.
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Stress and IVF success
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.
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PCOS and Epilepsy Treatment
Women with
epilepsy who are treated with a medication called
valproate (Depakote) have a higher incidence of
PCOS symtpoms. There is some evidence to suggest that the higher the dose of
Depakote used, the greater the chance for developing
PCOS. Stopping
valproate therefore may improve signs and symptoms of
PCOS.
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Egg Donation May Complicate Pregnancies
Egg donation uses the technology of
in vitro fertilization - IVF to obtain eggs from one woman, the
egg donor, fertilize them in the laboratory and then place the embryos into another woman, the recipient.
Egg donation is most commonly used when the recipient is older and thus less likely to get pregnant using her own eggs.
Egg Donation, Complications and Age
Egg donation pregnancies have lower rates of complications such as miscarriage and Down's Syndrome since the
egg donor is younger and therefore produces embryos with a lower rate of chromosomal abnormalities and thus lower rates of these problems. Some complications of pregnancy do not change with
egg donation. These are problems that are based on the age of the recipient. As women age, they have a higher incidence of complications such as gestational diabetes, pregnancy induced hypertension, intrauterine growth restriction. Older women also deliver by cesarean section more commonly. The increased risks have been thought to occur equally whether or not a woman used
egg donation to acheive the pregnancy.
Egg Donation Study
A recent study presented at the annual meeting of the Pacific Coast Obstetrical and Gynecological Society has suggested for the first time that women who conceive by
egg donation may be at higher risk for pregnancy induced hypertension (PIH).
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Medical Treatment of Varicocele
Last updated / published 4/15/2005
Varicocele and infertility
Varicocele is a finding in men where enlarged or dilated veins occur in the blood vessels of the scrotum. Normally the scrotal veins have valves that regulate the blood flow. However, in some cases, the valves are absent or defective and the blood does not circulate out of the testicles efficiently. This results in swelling of the veins above and behind the testicles. 85% of varicoceles develop in the left testicle.
It is estimated that varicoceles are present in about 20% of the normal male population and up to 40% of an infertile population. It is uncertain how varicoceles may cause infertility. Some evidence points to the increased temperature of the blood raising the temperature of the testes, which then damages the sperm. Heat can damage or destroy sperm. The increased temperature may also impede production of new, healthy sperm. Another theory is that in men with varicocele, the testicular fluid which carries sperm has an increased concentration of chemicals which can damage sperm. The chemicals are called reactive oxygen species or ROS.
Previously, varicoceles have been treated using various types of surgical procedures.
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Smoking reduces IVF Pregnancy Rates
In a study about to be published in the journal
Human Reproduction,
infertile women who smoke were found to have lower pregnancy rates and higher miscarriage rates during treatment with
in vitro fertilization - IVF.
Smoking reduced IVF pregnancy rates
Danish researchers looked at 8,457 women aged 20 to 40 who had had
in vitro fertilization treatment. The patients were divided into four groups, depending on the cause of each couple's fertility problems; male fertility disorder, fallopian tube problems, other clinical explanations - such as polycystic ovaries or endometriosis, or unexplained fertility problems.
Overall, the live birth rate for smokers was 28% lower than non-smokers. Among women with unexplained infertility, the live birth rate was a third lower for smokers, at 13% compared to 20% for non-smokers. This is the same effects as would be seen for women who were ten years older. In other words, a 35 year old woman who smokes would have the pregnancy rate a 45 year old.
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