Do IVF And Other Infertility Tech Lead To Health Risks For The Baby?

When patients come to Dr. Molly Quinn for infertility treatments like IVF, they usually aren’t too interested in hearing about the possible downsides, she says. They just want to get pregnant.

Still, she always discusses the risks of procedures such as IVF. For example, there’s an increased likelihood of twins or triplets — which increases the chances of medical complications for both moms and babies. And stimulating the ovaries to ripen extra eggs can, in a small number of cases, cause the ovaries to rupture.IVF

Quinn, an infertility specialist and assistant professor of obstetrics and gynecology at the University of California, Los Angeles, now has a new hazard to consider. According to research published this month in the Journal of the American College of Cardiology, children conceived through certain infertility treatments may be at a higher risk for cardiovascular disease.

Parents shouldn’t panic, the study’s authors say: The findings are preliminary, and the study cohort was fairly small. Still, they say, it means that families who used infertility treatments like IVF should be particularly vigilant about screening for high blood pressure in their children and help them avoid other cardiovascular risk factors, such as smoking, obesity and a sedentary lifestyle.

“Fertility clinics should really … counsel about potential risks for their kids,” says Dr. Urs Scherrer, a visiting professor at the University of Bern in Switzerland and a senior author of the study.

Scherrer and his colleagues followed the health of children conceived through assisted reproductive technology for more than a decade. ART is an umbrella term that covers a number of different types of procedures, including in vitro fertilization, in which sperm and eggs are mixed in a lab dish, and intracytoplasmic sperm injection, in which sperm are inserted directly into eggs. Today, roughly 2 percent of all births in the U.S are conceived via ART.

In 2012, the same team of scientists published a major paper showing that 65 healthy kids born with the help of ART were more likely than their peers to have early signs of problematic blood vessels. The current study, comparing 54 of those original children with 43 age- and sex-matched peers, shows those early irregularities — signs of “premature vascular aging”, the scientists say — persist into adolescence and young adulthood.

Kids in the study who were conceived via ART are now 16 years old, on average, but have blood vessels resembling those of middle-aged adults, the scientists found.

NPR.org, by Mara Gordon, September 19, 2018

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As evidence supporting LGBTQ families mounts, legal hurdles loom

New studies say kids of gay parents are just as well-adjusted as those with a mom and dad. But Congress is moving to allow adoption agencies to bar LGBTQ families.

LGBTQ families made headlines twice this month, but for very different reasons.

Last week, a study found that from a mental health perspective, adult children with lesbian parents fared just as well as their peers with opposite-sex parents. This follows an Italian study released in May that found that children with same-sex parents were actually slightly better off psychologically than children with a mom and a dad.LGBTQ families

Earlier this month, however, Republican lawmakers dealt a blow to LGBTQ people seeking to become LGBTQ families. The House Appropriations Committee approved an amendment allowing foster care and adoption agencies that receive federal funding to refuse to work with same-sex couples on religious or moral grounds. Though the amendment has several steps to go before becoming federal law, 10 states already have a similar law in place.

The House amendment goes even further than current state-level laws. It would cut 15 percent of child welfare funding to states that explicitly prohibit agencies from excluding LGBTQ people.

Independent and private adoption agencies that do not receive federal funding are already allowed to deny LGBTQ people.

The studies of children with same-sex parents don’t surprise advocates of LGBTQ families. Zach Wahls, who was born to a lesbian couple through artificial insemination and famously defended same-sex parents to the Iowa Legislature in 2011, said it was exciting to have studies to back up his experience.

“In our current climate, we’re at risk of backsliding on this issue,” Wahls told NBC News. “We need to be ready to contest that, and now we can do it in a scientific way.”

Scientific as they may be, the studies are unlikely to move those who advocate for allowing agencies to exclude LGBTQ families, because the objections are faith-based and do not pertain only to lesbian, gay, bisexual and transgender people.

by Avichai Scher NBCNews.com, 

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Arizona Governor Signs New Human Embryo Law

When a couple is unable to conceive naturally or medical treatments — like chemotherapy — make future pregnancies unlikely, there are a variety of fertility options available, including harvesting a woman’s eggs, freezing them and using them at a later date.

Up until now, reproductive fertility law specialists in Arizona would help couples navigate any tricky ethical issues that might arise in the future, like what happens if you split up or divorce before you decide to use the eggs.Arizona Embryo

But, a new law signed Tuesday by Gov. Doug Ducey has the potential to upend any contractual agreements written between husbands and wives or domestic partners, and dictates who is allowed to keep frozen eggs after a breakup.

Cathi Herrod, President of Center for Arizona Policy, said the new human embryo law helps make the law clearer and it is a positive step for Arizona.

“Just like a judge will decide when there are disputes over property, disputes over who gets the family dog — now who gets the family embryos will also be decided by a judge according to the law,” Herrod said.

by Lauren Gilger, KJZZ.com, April 4, 2018

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NY requires infertility coverage for all

New York’s health insurers will be required to provide coverage for fertility treatment regardless of marital status or sexual orientation, according to new state guidelines.

The state Department of Financial Services unveiled the new guidelines Wednesday, circulating a letter to insurers across the state making clear that they can’t restrict fertility-related coverage if the patient otherwise qualifies.health insurance

“All women who wish to have a child are entitled to insurance coverage for fertility treatment regardless of their sexual orientation or marital status, just as all women have the right to reproductive choice and to decide if and when to start a family, and New York will always stand up to protect and preserve those rights,” Gov. Andrew Cuomo said in a statement.

The new guidelines are based on the state department’s interpretation of “infertility.”

State law requires insurers to cover treatment for infertility and use the American Society for Reproductive Medicine’s definition of the term to determine when fertility-treatment coverage kicks in.

he society defines infertility as the “failure to achieve a successful pregnancy after 12 months or more of appropriate, timed unprotected intercourse or therapeutic donor insemination.”

But that definition is silent on marital status and sexual orientation, which the state’s new guidelines attempt to clear up.

Under the new guidelines, insurance companies must provide coverage for all individuals who meet the society’s definition of infertility, regardless of their sexual orientation or relationship status.

“If an individual meets the definition of infertility and otherwise qualifies for coverage, then an issuer must provide coverage regardless of sexual orientation, or marital status or gender identity,” Financial Services Superintendent Maria Vullo said in a statement.

by Lindsay Riback, The Journal News, 4 /19/2017

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Colorado Supreme Court to weigh if one parent has the right to use frozen embryos if the other objects

During three emotional days of divorce talks, Drake and Mandy Rooks managed to agree on how to divide up almost every aspect of their old lives down to the last piece of furniture. Only one thing remained: the frozen embryos.

There were six of them, created from his sperm and her eggs, and they had been left over from when the couple had gone through in vitro fertilization some years earlier.

The couple had had three children using the technology, and Drake was done. He didn’t want any more children in general, and certainly not with Mandy. She felt differently. She had always imagined a large family and, given her trouble getting pregnant, she thought the embryos were her only hope for having more babies. She wanted them preserved.

The dispute is one of a number of embryo-custody battles that have landed in the courts over the past quarter-century, resolved by different judges in different states with no consistent pattern. Rulings sometimes have awarded the frozen contents to the parent who wanted to use them, while other times determining that they could be discarded.

On Tuesday, the Colorado Supreme Court will hear oral arguments in the Rookses’ case. Although several other cases have made their way to states’ high courts, legal experts say the issues here are different.donor conceived

“Constitution questions are front and center in a way that they have not been in the other cases,” said Harvard law professor Glenn Cohen. And if the judges decide the Rookses’ dispute on such grounds, that would allow it to be appealed to the U.S. Supreme Court – where a ruling would apply nationwide.

Cohen said the central issue focuses on how to balance one person’s constitutional right to procreate with another’s countervailing constitutional right to not procreate. The question parallels similar arguments used in other reproductive health cases, namely the Supreme Court’s landmark 1973 abortion decision in Roe v. Wade. If women have the right to not be forced to be a gestational parent, do men – or women – have the right not to be forced to be a genetic parent?

Absolutely, says Drake Rooks, 50. “It just seems like a guy should be able to decide whether he wants more children or not and with whom,” he said in an interview last week.

Mandy Rooks, who is 10 years his junior, flips the argument and comes to the opposite conclusion. “No one,” she said in an emailed statement, “has the right to tell me that I have to kill my offspring.”

By | The Washington Post – January 8, 2018

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Couples win lawsuit over donated eggs with genetic defect

Two couples that gave birth to children with a genetic defect later traced to donated eggs won a lawsuit against a New York fertility doctor and his clinic in the state’s highest court Thursday.

The two children, both born in 2009, have Fragile X syndrome, a genetic condition that can lead to intellectual and developmental impairments. The parents, identified by initials and last names in legal papers, were told the egg donors were screened for genetic conditions.genetic defect

The parents are seeking legal damages for the added expenses of raising a disabled child. The amount of the damages was not set by the court and will likely be determined in further legal proceedings.

The case hinged on the state’s medical malpractice statute of limitations, which bars lawsuits filed more than two and a half years after the alleged act of malpractice — or the patient’s last treatment by the physician.

The lawsuits were filed two years after the children were born, when the condition became apparent, but more than two and a half years following the final treatment at the clinic. The egg donors were tested after the children were born and found to be carriers of the Fragile X mutation, according to court filings

Attorneys for the Reproductive Medicine Associates clinic and physician Alan Copperman argued the suit was filed too late, because the statute of limitations began counting down when the women ended fertility treatment after becoming pregnant, and not when the children were born or when the genetic abnormality was diagnosed.

December 14, 2017 – AP via New York Daily News

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PGS – New Study addresses impact of preimplantation genetic screening on donor oocyte-recipient cycles in the United States

Preimplantation genetic screening, or PGS, as practiced in donor oocyte-recipient cycles over the past 9 years, has not been associated with improved odds of live birth or reduction in miscarriage rates.

PGS Study ObjectivePGS, PGD

Our objective was to estimate the contribution of preimplantation genetic screening to in vitro fertilization pregnancy outcomes in donor oocyte-recipient cycles.

PGS Study Design

This was a retrospective cross-sectional study of US national data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System between 2005 and 2013. Society for Assisted Reproductive Technology Clinic Outcome Reporting relies on voluntarily annual reports by more than 90% of US in vitro fertilization centers. We evaluated pregnancy and live birth rates in donor oocyte-recipient cycles after the first embryo transfer with day 5/6 embryos. Statistical models, adjusted for patient and donor ages, number of embryos transferred, race, infertility diagnosis, and cycle year were created to compare live birth rates in 392 preimplantation genetic screening and 20,616 control cycles.

PGS Results

Overall, pregnancy and live birth rates were significantly lower in preimplantation genetic screening cycles than in control cycles. Adjusted odds of live birth for preimplantation genetic screening cycles were reduced by 35% (odds ratio, 0.65, 95% confidence interval, 0.53–0.80; P < .001).

PGS Conclusion

Preimplantation genetic screening, as practiced in donor oocyte-recipient cycles over the past 9 years, has not been associated with improved odds of live birth or reduction in miscarriage rates.

November 2017, American Journal of Obstetrics and Gynecology 

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Irish government to pay for couples to have IVF treatment and outlaw commercial surrogacy

The Government will today commit to funding IVF treatment for couples unable to conceive from 2019.

Minister for Health Simon Harris is to bring a memo to Cabinet this morning outlining proposed regulatory measures for the area of assisted human reproduction.IVF

It is understood Mr Harris will commit to outlawing commercial surrogacy and the payment for egg, sperm or embryo donors.

The memo will provide for an ethical framework with clear rules for the welfare of the child, woman and informed consent.

Speaking on his way into the Cabinet meeting on Tuesday morning, Mr Harris said that by the end of the year he wants to clarify for families what financial assistance would be available for IVF from 2019.

“I made it very clear that I want to put in place supports to help subsidise the cost of IVF for families,” Mr Harris said.

“One in six of us could experience infertility challenges at any time and I would like to by the end of the year be in a position to provide clarity to families in terms of what supports we may be able to provide from 2019.”

Mr Harris said the Assisted Human Reproduction Bill will “regulate this whole area”.

“I hope to send it to the Oireachtas Committee subject to Cabinet approval for pre-legislative scrutiny and get it passed into law in 2018 with the idea of having public subsidies for IVF for 2019,” he said.

The Irish Times, October 3, 2017

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Lesbian couples can now have children who are a part of each of them

Over the years I’ve had many lesbians tell me they want children but don’t see themselves being pregnant. It’s not part of their “body image.”

At some level, I understand this feeling. Our gender identity and sexual identity are tied up in our body image and feelings of sexual desire. Being pregnant and carrying a baby inside is an incredibly unique, womanly experience. Men have no idea what this is like, despite how much some may try.

As an experienced obstetrician who’s cared for many pregnant women throughout their pregnancies and deliveries, and as a gynecologist who has cared for and has performed gynecologic surgeries for women for the past thirty years, I’ve seen first-hand the many phases of reproductive health (and experiences with ill health) that only women can experience.IVF

I understand that some women may not identify with parts of that spectrum. For a lesbian couple it is sometimes easy to decide who will carry the pregnancy, while other couples struggle mightily with this uniquely lesbian decision. For single lesbian women, the choice can become more complex: to carry oneself and maybe go into new self-awareness territory, or to utilize the reproductive assistance of a gestational carrier.

We usually reserve gestational surrogates for women with a clearly defined medical need for surrogacy, yet lesbian women can often have very real issues that educate their life choices. Is body image a medical necessity for surrogacy? I believe that it can be if it’s tied into a woman’s sexual identity and sense of self.

We are very fortunate to live in a country where reproductive options are now available for all individuals regardless of gender, sexual identity, or marital status. This is not the case across Europe and other parts of the world. In my practice I see many patients from across the globe – from China, Europe and elsewhere – who travel for reproductive treatment options that are illegal where they live.

All women, and in particular lesbians, who might consider having children someday should talk with their doctor about reproductive options available, or ask for a referral to a fertility specialist to review the treatments that may best apply to their situation. It is imperative that lesbian women seek out a practice that is comfortable providing care to lesbians and same-sex couples.

By Dr. Guy Ringler, LGBTQNation.com – September 12, 2017

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TIAA adds LGBT benefit to help female couples with family planning

Investment advisory firm TIAA has added reciprocal IVF assistance to its family planning benefits package as an LGBT inclusion measure.

The New York City-based firm officially added the benefit July 1 after conversations with its LGBT employee resource group during Pride Month in June.

“The addition of reciprocal IVF [meaning one partner supplies the eggs to be used for IVF, while the other partner is the gestational carrier of the pregnancy] could significantly help female couples achieve their family planning goals, and we want to provide them with the same support other employees already receive,” says Skip Spriggs, senior executive vice president and chief human resources officer at TIAA. “It wasn’t a cost issue, but it was about creating the right environment.”TIAA

Prior to this benefits addition, employees had to go through a pre-certification process with a claims administrator to verify infertility, says TIAA. Now, employees can have IVF services covered without verifying that they tried natural or artificial insemination. Similarly, female couples don’t have to provide infertility to gain access to IVF as a covered benefit, the firm says.

Only 57% of employers offer a type of infertility service coverage, and 25% of the employers cover IVF, according to Mercer’s 2016 “National Survey of Employer-Sponsored Health Plans.”

by Amanda Eisenberg, August 21, 2017 – benefit news.com

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