In Vitro Fertilization

Is There an Association Between Drinking and IVF?

Does alcohol consumption affect fertility and in vitro fertilization (IVF)? In the United States, the percent of adults age 18 years and older who have at least one heavy drinking day in the past year is 25%. Heaving drinking is defined by 5 or more drinks for men and 4 or more drinks for women, according to the Centers for Disease Control and Prevention canstockphoto42020889(CDC). Based on reports from the National Institutes on Alcohol Abuse and Alcoholism, 87% of people age 18 or older reported drinking alcohol at some time in their lives, and 56% admitted to drinking during the past month. These statistics are from a 2013 survey.

 

In vitro fertilization is a series of procedures used to help couples become pregnant. During IVF, the woman takes medication to help with egg development through a process called ovarian stimulation. The eggs are retrieved via a simple medical procedure. Then, eggs are placed in a laboratory petri dish and fertilized with the male partner’s sperm. Once embryos develop, they are placed inside the female partner’s uterus in a process called embryo transportation.

 

In a recent study conducted by Rossi and associates, researchers evaluated more than 4,700 in vitro fertilization (IVF) cycles that involved more than 2,500 couples. During the investigation, couples were given questionnaires regarding their alcohol consumption at the start of the IVF cycle, but not during the cycle or pregnancy. The main outcome the researchers were interested in was the live birth rate following IVF. Investigators found that for women or men undergoing IVF, drinking 4 or more alcoholic drinks per week before the IVF cycle was associated with a 48% increased risk for failed fertilization. In addition, the risk for live birth was 21% lower.

 

Alcohol appears to have a negative effect on fertility. However, the researchers stress that while there is much published evidence related to adverse effects of alcohol upon the fetus during pregnancy, there is little data regarding alcohol’s effect on fertility. Additionally, experts theorize that couples undergoing IVF usually cannot conceive without assistance, and therefore, these individuals may not limit alcohol consumption before the IVF cycle. In this study, infertile couples IVF treatment photoreported less drinking than the general population, with 44-66% reporting alcohol use and 62-74% reporting being regular drinkers.

 

In a study conducted at Harvard Medical School, researchers asked 2,574 couples about their alcohol consumption before they went through IVF treatment. Based on reports, 56% of women and 33% of men reported less than one drink a week. In addition, 4% of women and 5% of men consumed at least one drink every day. Dr. Rossi, lead researcher, reported that women and men who drink 6 units of alcohol each week significantly reduced their likelihood of pregnancy.

 

At this level of consumption, women were at least 18% less likely to have a successful delivery with IVF, and men reduced chances of fatherhood by at least 14%. The IVF success rates were also influenced for men who drank beer and women who drank white wine. In this study, the average age of the men was 37, and the average age of women was 34.

 

Based on the guidelines from the National Institute for Health and Clinical Excellence (NICE), women should stop drinking before conception and during pregnancy. The link between conception and alcohol is an area where the evidence is not clear. In addition, couples who struggle with fertility are more affected by alcohol consumption than those who are fertile.

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Overview of the Influenza Vaccine during Pregnancy

Influenza (also called “the flu”) is more likely to cause severe illness for healthy, pregnant women compared to those women who are healthy and not pregnant. During pregnancy, a woman’s body has changes in the heart, lungs, and immune system, which makes them more prone to severe illness with the flu.

 

Getting the flu while pregnant can raise the risks of pregnancy complications as well. This include premature labor, earlycanstockphoto42586901 delivery, and heart infections. Studies show that vaccinating a pregnant women will pass the antibodies on the baby so the child will be protected from the flu for at least 6 months after the birth. The Centers for Disease Control and Prevention (CDC) recommends that pregnant women receive a flu shot during any trimester of pregnancy to protect themselves and the unborn child. The nasal spray used to immunize against influenza is not recommended, however.

 

Is it safe for pregnant women and their unborn children to get a flu shot?

 

The flu shot has been given safely to many pregnant women over the past few decades. Much scientific literature supports the safety of the flu vaccine in pregnant women, as well as the unborn babies. The CDC is continuing to get data regarding this topic.

 

What side effects do pregnant women experience with the flu shot?

 

The most common side effects pregnant women experience are the same as other people who receive the flu vaccine. These side effects are mild and include:

 

  • Fainting
  • Soreness, swelling, and redness at the site
  • Headache
  • Fever
  • Muscle aches
  • Fatigue
  • Nausea

 

When side effects occur, they typically begin right after the influenza shot is given, and they only last for a couple of days. It is rare for someone to have an allergic reaction to the flu shot, as healthcare professionals screen for risk factors.

 

Can pregnant women who have egg allergies receive the flu shot?

 

Most people who have an allergy to eggs should not receive the flu shot. A person with a severe allergy to any vaccine component, such as egg protein, is at risk for a life-threatening anaphylactic reaction. Pregnant women need to tell the healthcare workers about their allergies before getting immunized.

 

How is the safety of flu vaccines monitored in pregnant women?

 

The Food and Drug Administration (FDA) conducts ongoing safety monitoring on all vaccines licensed for use in the United States. The CDC and FDA use two systems to monitor the influenza vaccine safety for women during pregnancy. These include:

 

  • Vaccine Adverse Event Reporting System (VAERS) – This is an early warning system that monitors for problems during vaccination. Anyone can report vaccine side effects, and health concerns that arise after vaccination. These reports also help indicate if further investigations are necessary.

 

  • Vaccine Safety Datalink (VSD) – This is a collaboration between many health organizations that uses ongoing monitoring approaches and searchers of vaccine data.

 

Have studies been conducted by the CDC regarding flu vaccine safety during pregnancy?

 

Many studies were conducted by the CDC and partner organizations. A review of VAERS in 2011 found no link between pregnancy complication or fetal outcomes among women who received a flu shot while pregnant. In addition, a study involving VSD in 2013 found no increased adverse obstetric events for these women, which included pre-eclampsia, chorioamnionitis, and gestational hypertension.

 

Can a breastfeeding woman get the flu shot?

 

Breastfeeding women are encouraged to get the flu vaccine, according to the CDC. If the mother gets influenza, it could pass on to her newborn infant, which puts the baby at great risk.

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Detecting Chromosomal Disorders through Pre-Genetic Diagnosis

Pre-genetic diagnosis (PGD) is the use of genetic testing technology to assess and evaluate embryos for abnormalities. Also called preimplantation genetic diagnosis, PGD can be performed using many techniques available. In the in vitro fertilization (IVF) process, an egg is fertilized with sperm in the laboratory setting. After a few days, the resulting embryo is biopsied for genetic analysis. This allows the embryologist to evaluate if or not the embryos are genetically normal or if chromosomal abnormalities exist.

Why are embryos analyzed?

Fertility Clinic DubaiEmbryos are analyzed for one or more reasons. These include:

  • Gender selection – For family balancing, the embryologist can assess the embryo’s gender.
  • Aneuploidy – With this condition, there is an extra chromosome or a missing one. Down Syndrome is an example of aneuploidy, which is more common as a woman ages.
  • Translocations – This refers to a change in chromosome structure, where chromosomes are attached to each other, or where pieces of two different chromosomes are interchanged.
  • Recurrent pregnancy loss – Certain genetic defects can cause repeated pregnancy losses.
  • Single gene disorders – Diseases or conditions caused by an inherited single mutated gene. Examples include Sickle Cell Anemia, Cystic Fibrosis, and Tay Sachs.

The PGD Process

The pre-genetic diagnosis can be done using different approaches. These are:

  • Microarray method – This form of preimplantation genetic screening requires a blood test from the parents to create a DNA fingerprint. This can be used to compare the DNA from the assorted embryos to make sure there is one chromosome from each parent for every 23 pairs of chromosomes. This technique has the ability to test all chromosomes in less than two days. In addition, this test can be used to calculate the estimated accuracy of the result, which avoids errors.
  • Fluorescent in situ hybridization (FISH) – With this method, a single cell is analyzed under the microscope. Fragments of DNA are specified to each chromosome being tested using microscopic markers and fluorescent single detection.
  • Comparative genomic hybridization (CGH) – Also called a blastocyst biopsy, CGH tests the chromosomes expelled by the eggs during cells division after fertilization. This involves using cells of a day-5 embryo.

How accurate is PGD?

The accuracy of preimplantation genetic testing varies from couple to couple. There is a chance that PGD will not be 100% reliable. However, accuracy rates are 98% for most couples.

After the ResultsIVF treatment photo

Once PGD testing results are available, the fertility specialist discusses them with the clients, and only normal embryos will be used for IVF cycles. One or two embryos are placed in the woman’s uterus, and extra embryos are frozen for later cycles. PGD allows the doctor to use genetically normal embryos for transfer, increasing the chances of IVF success. When all chromosomes are evaluated, and assessed as normal, the chances of pregnancy is around 85-90%.

PGD for Failed IVF Treatment

When a couple experiences a failed IVF cycle, PGD is recommended. One of the most common reasons IVF fails is genetic abnormalities of the embryos. Women may have factors that cause their ovaries to produce genetically abnormal eggs, which produce problems with the embryos. This will lead to unsuccessful IVF treatment. Egg donors can be an option when this is found. If the male’s sperm contributes the abnormal genetic material, donor sperm may be used.

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The Basics of IVF in Dubai

In Vitro Fertilization (IVF)

On day 14 of a normal menstrual cycle, an egg is released from the ovary in a process called ovulation. The egg goes into the fallopian tube where it is fertilized. After remaining in the tube for several days, the egg develops into an embryo, which enters the uterus and implants into the endometrium (uterine lining). With in vitro fertilization, the sperm does not have to travel to the fallopian tube to fertilize the egg.

IVF is an advanced reproductive technology (ART) process first used successfully in England in 1978. In the beginning, IVF was only used to treat infertility related to blocked fallopian tubes. Now, IVF has evolved to be an effective treatment for many causes of infertility. IVF can be used when other treatments fail, and many fertility clinics now report a 50% success rate using IVF.

Indications for IVF

Many diagnoses lead a couple to undergo IVF. The most common indications for IVF include:

  • Male factor infertility
  • Fallopian tube damage
  • Tubal ligation
  • Advanced maternal age
  • Endometriosis
  • Recurrent pregnancy loss
  • Genetic abnormalities
  • Unexplained infertility

The IVF Procedure

With the IVF process, the ovaries are stimulated using certain medications so they mature multiple eggs. Vaginal ultrasounds and blood testing is done to monitor the development of the eggs. Once eggs are mature, they are removed from each ovary using a minor surgical procedure. Once retrieved, the eggs are placed into a petri dish and exposed to the male partner’s sperm. After several days, the egg cells divide and become embryos. After determining which embryos are viable and of high-quality, the embryos are placed into the woman’s uterus using a small catheter inserted through the cervix. Extra embryos are frozen (cryopreserved) for later use.

Laboratory Procedures

The IVF laboratory procedures involved include:

  • Intracytoplasmic sperm injection (ICSI) – If fertilization is problematic due to sperm shape or motility issues, ICSI is used. Donor sperm may be used in the case of a low sperm count. With ICSI, a single sperm is injected into the egg using microtools and microscopic technology.
  • Assisted hatching – When the outer layer of the embryo (zona pellucida) is thick, the embryo may have trouble breaking free, or “hatching.” Assisted hatching involves making a tiny hole in the shell before transferring to the uterus. This allows embryos to implant into the uterine lining easily.
  • Embryo freezing – Cryopreservation (egg freezing) is done 3-8 days after the embryos form. These embryos have the potential to become successful pregnancies later on.
  • Preimplantation genetic diagnosis (PGD) – This form of testing involves removing a single cell from the developing embryo to analyze it for chromosomal and genetic abnormalities.
  • Egg freezing – For women who do not wish to become pregnant until years later, egg freezing is an option. Women who are candidates include those in their 30s who wish to delay child bearing, those with cancer who are going to receive chemotherapy, and those who are having IVF and do not wish to freeze embryos.
  • Trophectoderm biopsy – A new technique used to screen embryos and to select those most likely to result in pregnancy. Cells are removed from the embryo during the blastocyst stage. This test is used for women with recurrent pregnancy losses, as well as those at risk for chromosomal abnormalities.

PRC Dubai offers in vitro fertilization at a first rate fertility center in Dubai Healthcare City. After two decades of IVF success in the US, PRC is now open in Dubai. With an in-house laboratory, the Dubai fertility clinic offers exceptional and comprehensive treatment options. Call us today!

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