Saturday, July 29, 2006

New drug for recurrent miscarriage

GroPep, an Australian company, was just granted the European patent for their drug PV903. From the press release: "GroPep is currently conducting a phase I clinical trial on PV903 to evaluate the safety and tolerability of vaginally administered PV903 gel and to determine whether PV903 has effects on vaginal immune cells in a manner consistent with its proposed role in treating immune-based infertility. Results from the trial are expected during the second half of 2006 and if successful, GroPep will seek to partner PV903 with an international pharmaceutical or biotechnology company with an established franchise in reproductive medicine. "

Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies before reaching 20 weeks of gestation. GroPep states that "It is estimated that some 50% of all cases of recurrent miscarriage are the result of an inappropriate maternal immune response that treats the fetus as “foreign” and ultimately results in pregnancy loss. " Their site also elaborates on the scientific background of PV903. Personally, I would have liked to have seen references to medical articles, but they do mention the university at which the research was done.

In brief, research showed that an immune response can occur prior to conception, this response later causes diminished placental growth, immune rejection of the fetus and miscarriage.

If the clinical studies work out the way they would like them to, PV903 will be administered vaginally after intercourse. The drug will alter the female immune system and allow a strong and healthy pregnancy to occur.

Sounds promising.

Sunday, July 23, 2006

OMG What do you say?

Way back, when I fantasized about making ovulation kits affordable in Israel (it worked, the price has gone way down), I started importing and selling ovulation kits on a website that I made. There was very little money in it but I kept up with it almost as a public service. So, in addition to selling tests (which means packaging them on my own and sending one slave or another over to the post office) I also give tips on how to use them over the phone.

About 18 months ago, Diana started calling me. At first she thought she was missing her ovulation because her cycle was short and she waited twelve days before going to the Ritual Bath (links to a book I really enjoyed by Faye Kellerman). I gave her tips about who she could call for help, like Puah - an organization that combines infertility with halacha (Jewish law). Finally, she convinced me to sell her fertility tests (that I insisted she didn't really need) and then she called me for support practically daily for the next two months. Later, her husband was tested and it turned out that they were definitely going to have difficulty conceiving naturally... The last time I talked to her was shortly after she'd gotten that news. That is, until today.

Today Diana called and told me she had good news. She'd gone through her 2nd IVF cycle and it was successful. Well, kind of successful. Before she let me congratulate her she told me what was troubling her. Her first beta was 32. Her second beta, 4 days later, was 35.

Having gone through a pregnancy that started with a beta of 29, I remembered from my research at the time, that starting with such a low beta usually isn't that great. A beta not doubling isn't necessarily a problem very early on, but barely going up after 4 days & staying that low is definitely bad. I hated to be in the position of telling her that it was pretty likely that it wasn't going to work out.

She called me back later, looking for a shred of hope. Maybe something she could eat would make it better? Maybe because the estrogen & progesterone levels were good that it would be OK? Maybe more than one had implanted and then only one remained? And then came the guilt - maybe it was something that she did? Maybe she didn't pray hard enough? I did everything I could to reassure her that it wasn't something that she did and also that there was nothing that she could do.

I wish I could have given her hope. I told her my story. With a first beta of 29 & then 35... weeks of not knowing what was happening (my fetus was hiding behind the huge hematoma (blood clot) that ended up washing it out - the first time I saw a sac was at 8 weeks & then, suddenly there it was, a fetus with a heartbeat, exactly the right size for 8 weeks). I waited to miscarry, knowing that it would happen, but my baby kept growing normally and as the time went by, I thought I might beat the odds... After weeks of bleeding on and off and two weeks of complete bedrest, I lost the pregnancy at 13 weeks. Warning: Stupid ultrasound technician comment ahead. My mom drove me to the hospital and the technician who finally saw me said, "Are you sure you were pregnant?" Huh?!? I'd had an ultrasound at 6 that same evening & I saw the fetus with its arms and legs moving around. I'd miscarried at home & I didn't even know... (Obviously, the bleeding and cramps had been really bad, I did know I was miscarrying, I just didn't know it was already over.) No, I didn't go into all that detail with Diana, it just went through my head. I was thinking that I hope for her sake that if it's going to end it ends quickly.

Although I wanted my pregnancy to continue, knowing that it probably wouldn't definitely made the miscarriage less tragic for me. Maybe knowing the truth early on is the best?

Diana told me she's too drained to go through another cycle. I told her that she'll do it when the time is right for her and that I'll be waiting for her to call me with the good news. I know she will.

Sunday, July 16, 2006

IVF in a war zone

Picture this. You're supposed to go in for IVF early Sunday morning and the city in which you live is bombarded with Katyusha rockets on Friday night and Saturday... You get your trigger shot as you're anxiously watching the news and hoping and praying that things aren't going to be so bad by Sunday that your retrieval won't be able to go on as planned. (From what I understand you *have* to have the retrieval if you've had the trigger shot, so it seems that the retrievals will go on as planned.)

I went through my first IVF cycle at Haifa's Rambam Hospital. Picturing the women going in today was scary. I checked in at one of the forums I read - some messages were like this message from 'honey', "If you need a place to stay, I live in {name of city} and you're welcome to stay with me. My fridge is equipped with Decapeptyl, Progynova, Endometrin, and Pregnyl - so we're in good shape." or this from 'Lilach81' - "We live up north and are currently staying in the center of the country. I have an appointment today which I (obviously) can't make - I need advice from women in this area about a doctor who can perform an ultrasound and blood tests for me..." (At least there's socialized medicine in Israel, so cost won't be a factor in most cases.)

I can only imagine what these women are going through. Going through IVF is stressful enough without it being performed in a war zone... I want to send my best wishes to those women on both sides of the border who are going through IVF at this difficult time.

Wednesday, July 12, 2006

DI Dads speak up

Eric Schwartzman who runs a Yahoo group called DI Dads dropped me a line a while back to let me know about an article in USA Today about dads to kids born by donor insemination who are speaking up. It's about dads (and families) who've chosen to tell their children about the way in which they were conceived. Eric himself was interviewed for the article.

I found it interesting that Eric says that the term 'father' is used for the donor and dad for the social parent (the male parent raising the child). I like the separation between formal and functional... I really understand why it's important for these dads to speak up - they're making it legitimate to have children with the help of a donor. This will make it easier for future couples contemplating using a sperm donor and will make it easier for children who were conceived in this way.

When I was a kid, most adopted children didn't know they were adopted. Today, I think it's rare for a child not to know. I doubt that this change will happen as quickly with children born using donor insemination, but the work Eric and others like him are doing seems like a step in the right direction.

Monday, July 10, 2006

Stem to Sperm - A future solution for male infertility?

A team of scientists led by Professor Karim Nayernia in Newcastle University successfully grew sperm cells from embryonic stem cells. This article (from The Age) describes the research in further detail. A picture of the mice who were born as a result of the sperm grown in the lab can be seen here. The second article (from Daily Mail) says that the technique could allow men suffering from certain types of infertility to 'grow' their own sperm. One way in which this could be done is by surgical removal of immature sperm cells from a man's testicles and then growing them in the lab and replacing them. The article discusses additonal possible applications of the research.

Interestingly, the first article fails to mention that the resulting mice were far from healthy and suffered from a variety of medical conditions.

As with any new technique, this one too is at least five years from being available to men suffering from infertility, but it may offer hope for the future.

--- Unrelated Note ---

For all those who are interested, I've added the option to get an RSS feed for this blog. See the link on the right - clicking it allows you to choose where you'd like your feed to go.

Tuesday, July 04, 2006

Endometrial polyps and pregnancy

One of the questions that reached my inbox recently was, "Have you heard of anyone successfully conceiving with an endometrial polyp?" Truth? I haven't actually come across those terms together before... I decided to look it up and found a study done by Perez-Medina et al from the Santa Cristina University Hospital in Madrid, Spain.

The goal of the study was to determine whether polypectomy (removal of the endometrial polyp/s) prior to IUI (intrauterine insemination) affects pregnancy rates. The women were divided into two groups - one group who had a polypectomy prior to beginning IUI and one who did not. The overall pregnancy rate was 51.4% in the study group and 25.4% in the control group, with the conclusion being that polypectomy is indeed helpful. Surprisingly, 65% of the pregnancies in the study group occurred before the first IUI.

The researchers also noted that they found no significant correlation between the size of the EP (endometrial polyp) and pregnancy rates.