LONDON: Sperm saved for a ''rainy day'' has given a British cancer survivor a daughter 22 years later, in a double first for IVF.

When Richard Pott developed testicular cancer at the age of 21, doctors advised that he freeze samples of his sperm before embarking on treatment that might leave him infertile.

As a university student, having children wasn't a priority but he took their advice. Two decades later, Mr Pott is profoundly grateful that he did after becoming a father to Vivienne in a remarkable first for IVF treatment in Britain.

Vivienne, now 13 months old, was conceived using sperm frozen in 1987 – the oldest to create a child in Britain.

''I really want our story to give hope to other people who are in similar circumstances,'' Mr Pott said.

Once the embryos were created, using the thawed sperm, three were frozen before being transferred to the womb.

It is also thought to be the first time a baby has been born after this kind of double freezing.

Freezing sperm before having cancer treatment was relatively new in the 1980s but is now standard procedure for men.

Mr Pott, who works in banking, married Rebecca in 1999 and due to her problems with endometriosis in 2003 they were advised to start trying for a family soon. Despite his treatment, Mr Pott was able to produce fresh sperm and after two cycles of IVF, baby Henry, now five, was born.

The couple embarked on more IVF but after four failed cycles were on the verge of giving up. The couple then turned to what Mrs Pott called their ''rainy day sperm''. Dr Tarek El-Toukhy, of Guy's and St Thomas' assisted conception unit, in London, said: ''We believe this is the longest that sperm has been frozen and used successfully in Britain.''

Telegraph, London

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Baby conceived using 22-year-old sperm

NEW YORK (Reuters Health) – Almost half of women who said they'd been struggling to get pregnant for at least a year ended up having a baby despite not getting fertility treatment, in a new study from Australia.

That success rate was only slightly lower than in women who also reported trouble conceiving and opted for treatment with fertility hormones or in vitro fertilization (IVF).

“Many women aged up to 36 years with a history of infertility can achieve spontaneous conception and live birth without using fertility treatment indicating (they) are sub-fertile rather than infertile,” study researcher Danielle Herbert of the University of Queensland School of Population Health in Brisbane told Reuters Health in an email.

That means that if nothing is clearly wrong — men make enough sperm, and women are ovulating regularly — couples who have had trouble conceiving should still be optimistic they can get pregnant on their own, researchers said.

“I'm not surprised that women who were not treated still get pregnant — we know that,” said Dr. Courtney Lynch, head of reproductive epidemiology at The Ohio State University in Columbus, who wasn't involved in the new research.

“We know we can get women pregnant quicker if we have them go into IVF, but if we give women time, (many of them) can still get pregnant,” she told Reuters Health.

The research is part of a long-term study of more than 7,000 women living in Australia. Starting in 1996, participants filled out health surveys every few years, which included questions on pregnancy and childbirth.

The current data is from about 1,400 women age 28 to 36 who reported on the most recent questionnaires that they'd tried unsuccessfully to get pregnant for at least a year at a time.

Close to 600 of those women said they'd received infertility treatment using IVF or fertility hormones, including Clomid.

Through the latest survey in 2009, 53 percent of those women said they had a baby following fertility treatment, compared to 44 percent of women who'd had trouble conceiving but didn't seek treatment, the researchers reported in the journal Fertility and Sterility.

For women who did have a baby, there was no difference in pregnancy complications — including stillbirths or premature births — between those who did and didn't get fertility treatment.

AFTER A YEAR, GET CHECKED OUT

Herbert and her colleagues pointed out some limitations of the report, including that they didn't know if women changed male partners at any point during the study period, which could have affected their chances of becoming pregnant.

And one fertility researcher not involved in the new study said it's impossible to know whether women who didn't get treatment lost or gained weight, or changed their diet and lifestyle to improve their chances of becoming pregnant.

Alice Domar, of Boston IVF, said that the number of women who got pregnant without treatment after a year of infertility is higher than previous studies have suggested.

“What a lot of physicians feel is if you're not pregnant within a year, it usually means there's something going on,” she told Reuters Health.

Domar said that she'd still recommend a woman who's been trying to get pregnant for that long get checked out to see if there's anything preventing her from conceiving. If not, she can keep trying. But if, for example, her tubes are blocked, any extra waiting is “time out the window,” she said.

Lynch said that about 15 percent of women won't get pregnant after a year of trying, but only three to five percent of them are truly infertile. The rest will likely conceive on their own after another year or two.

“There are a lot of patients that don't want to wait another year, especially if you're an older patient,” Lynch said — and they might want fertility treatment, even if pregnancy without it may be possible.

“But if you're 28, I think waiting another year makes sense potentially before going on a treatment.”

According to Domar, most women who can't get pregnant will only need treatment with fertility hormones, which cost about a dollar a day, to get ovulation back to normal. IVF, on the other hand, runs for about $15,000 a cycle, and may or may not be covered by insurance.

'WOMEN SHOULD STILL BE HOPEFUL'

The findings can be seen as encouraging for some women, Domar said.

“It means if you've been trying for a year and you're young and you have unexplained infertility, according to this data you have a decent chance of spontaneously conceiving,” Domar said.

Dr. Sacha Krieg, an ob-gyn who studies recurrent pregnancy loss at the University of Kansas Medical Center in Kansas City, agreed.

“Women should still be hopeful that they're going to get pregnant, even if they've been trying for an entire year,” she said.

Still, Krieg told Reuters Health, “I wouldn't want this to (dissuade) women from seeing a fertility specialist and being evaluated.”

SOURCE: http://bit.ly/xbeB1L Fertility and Sterility, online January 23, 2012.

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Think you can't get pregnant? Try again, study says

A NSW couple are suing their IVF doctor because they say their 11-year-old son should never have been born.

Although they say they love their son, they believe if they had been aware of the likelihood of his illness, they say they would never have gone through with the pregnancy.

Debbie Waller gave birth to Keeden in August 2000 following IVF treatment.

Only days after his birth, baby Keeden suffered a stroke that caused him to never be able to walk, talk or go to the toilet. He suffers permanent brain damage, cerebral palsy and uncontrolled seizures.

The stroke was caused by a rare blood clotting condition, antithrombin deficiency, which Keeden inherited from his father, Lawrence.

There was a 50% chance that Keeden would inherit this gene, however the Wallers say they were never made aware of this fact.

Mrs Waller told the Sydney Morning Herald: “We love Keeden now that he's here, but if we had the right information and the right options we wouldn't have gone ahead with the birth, not in the way we did.”

They have taken their IVF specialist, Christopher James, to the NSW Supreme Court claiming ‘wrongful birth’ and seeking $10million in compensation to help care for their handicapped son.

The Wallers knew about Lawrence’s blood clotting condition and said they told Dr James about it.

In the first day of the hearing yesterday, Justice John Hislop heard that Dr James didn’t advise the couple on the likelihood of them passing on the condition to their baby and instead gave them details of a genetic counsellor at Wollongong Hospital.

The Wallers attempted to call the counsellor however the number was for the main switchboard and went unanswered.

The couple alleges Dr James didn’t mention the genetic counsellor again and began the IVF process.

David Higgs, SC, counsel for the Wallers told the court: “There was a duty of care on the part of Dr James to ensure that both he and the Wallers understood that this problem could be passed on and for there to be proper counselling and discussion about the other options they had, including the option of an anonymous sperm donor.”

Lawyers for Dr James will argue that the referral to a genetic counsellor met his responsibility as an IVF doctor.

It isn’t the first time the couple have been in court regarding their son. They also previously launched a negligence claim in the High Court in 2006 which was unsuccessful.

Read more:
Couple sues doctor for 'wrongful life' of their son

Just days after Mrs Waller gave birth in August 2000 following IVF treatment, Keeden suffered a massive stroke that caused severe brain damage and meant he was never able to walk, talk or go to the toilet.

The stroke was the result of a rare blood clotting condition known as antithrombin deficiency which Keeden inherited from his father.

Tragically, the Wallers did not know there was a 50 per cent chance that Keeden would have the defective gene.

They are now suing the IVF specialist who oversaw Keeden's conception – Wollongong-based Christopher James – in the NSW Supreme Court for what is known as ''wrongful birth'' and seeking compensation in the order of $10 million for the lifelong care of their handicapped son.

''We love Keeden now that he's here, but if we had the right information and the right options we wouldn't have gone ahead with the birth, not in the way we did,'' Mrs Waller said from her home in Kangaroo Valley.

''Had things been done right, Keeden would never have been here. He would never have to go through the suffering he goes through – the seizures and all.''

The case raises a number of legal questions and could set a precedent for other parents whose children have disabilities.

The Wallers told Dr James about Lawrence's blood clotting condition, and they claim he breached his duty of care to them by failing to take proper steps to find out whether it could be passed on by just one parent.

In the first day of the hearing yesterday, Justice John Hislop heard that Dr James did not seek to find out the answer himself, but handed the couple the name and phone number of a genetic counsellor at Wollongong Hospital on a post-it note. It is alleged the note was given to the Wallers in the context of a discussion about fertility not genetics, and that the phone number was the main switchboard for the hospital rather than the counsellor's direct line.

When the phone went unanswered the Wallers did not call back, and it is alleged that Dr James did not mention the genetic counsellor again, and began the IVF process.

''There was a duty of care on the part of Dr James to ensure that both he and the Wallers understood that this problem could be passed on and for there to be proper counselling and discussion about the other options they had, including the option of an anonymous sperm donor,'' counsel for the Wallers, David Higgs, SC, said.

It is not the first time the Wallers have been to court in relation to their son. In 2006, they launched an unsuccessful ''wrongful life'' case in the High Court on Keeden's behalf, in which he sought compensation for future loss of earnings and opportunity.

Lawyers for Dr James will argue it is not the responsibility of an IVF specialist to find out whether rare genetic conditions such as antithrombin deficiency can be passed on from father to son.

They claim that such responsibility as does exist was met by the referral of the Wallers to the genetic counsellor.

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IVF doctor faces $10 million lawsuit

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Keeden's $10m IVF case

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Couple sues IVF doctor for wrongful birth

Lifelong suffering … Debbie Waller says her disabled son, Keeden, 11, would not have been born if she had been warned about the chance of his hereditary condition. Photo: Quentin Jones

DEBBIE and Lawrence Waller love their 11-year-old son, Keeden, but they believe he should never have been born.

Just days after Mrs Waller gave birth in August 2000 following IVF treatment, Keeden suffered a massive stroke that caused severe brain damage and meant he was never able to walk, talk or go to the toilet.

The stroke was the result of a rare blood clotting condition known as antithrombin deficiency which Keeden inherited from his father.

Advertisement: Story continues below

Tragically, the Wallers did not know there was a 50 per cent chance that Keeden would have the defective gene.

They are now suing the IVF specialist who oversaw Keeden's conception – Christopher James – in the NSW Supreme Court for what is known as ''wrongful birth'' and seeking compensation in the order of $10 million for the lifelong care of their handicapped son.

''We love Keeden now that he's here, but if we had the right information and the right options we wouldn't have gone ahead with the birth, not in the way we did,'' Mrs Waller said from her home in Kangaroo Valley yesterday.

''Had things been done right, Keeden would never have been here. He would never have to go through the suffering he goes through – the seizures and all.''

The case raises a number of legal questions and could set a precedent for other parents whose children have disabilities.

The Wallers told Dr James about Lawrence's blood clotting condition, and they claim he breached his duty of care to them by failing to take proper steps to find out whether it could be passed on by just one parent.

In the first day of the hearing yesterday, Justice John Hislop heard that Dr James did not seek to find out the answer himself, but handed the couple the name and phone number of a genetic counsellor at Wollongong Hospital on a post-it note. It is alleged the note was given to the Wallers in the context of a discussion about fertility not genetics, and that the phone number was the main switchboard for the hospital rather than the counsellor's direct line.

When the phone went unanswered the Wallers did not call back, and it is alleged that Dr James did not mention the genetic counsellor again, and began the IVF process.

''There was a duty of care on the part of Dr James to ensure that both he and the Wallers understood that this problem could be passed on and for there to be proper counselling and discussion about the other options they had, including the option of an anonymous sperm donor,'' counsel for the Wallers, David Higgs, SC, said.

It is not the first time the Wallers have been to court in relation to their son. In 2006, they launched an unsuccessful ''wrongful life'' case in the High Court on Keeden's behalf, in which he sought compensation for future loss of earnings and opportunity.

Lawyers for Dr James will argue it is not the responsibility of an IVF specialist to find out whether rare genetic conditions such as antithrombin deficiency can be passed on from father to son.

They claim that such responsibility as does exist was met by the referral of the Wallers to the genetic counsellor.

More:
$10m 'wrongful birth' case

Lifelong suffering … Debbie Waller says her disabled son, Keeden, 11, would not have been born if she had been warned about the chance of his hereditary condition. Photo: Quentin Jones

DEBBIE and Lawrence Waller love their 11-year-old son, Keeden, but they believe he should never have been born.

Just days after Mrs Waller gave birth in August 2000 following IVF treatment, Keeden suffered a massive stroke that caused severe brain damage and meant he was never able to walk, talk or go to the toilet.

The stroke was the result of a rare blood clotting condition known as antithrombin deficiency which Keeden inherited from his father.

Advertisement: Story continues below

Tragically, the Wallers did not know there was a 50 per cent chance that Keeden would have the defective gene.

They are now suing the IVF specialist who oversaw Keeden's conception – Christopher James – in the NSW Supreme Court for what is known as ''wrongful birth'' and seeking compensation in the order of $10 million for the lifelong care of their handicapped son.

''We love Keeden now that he's here, but if we had the right information and the right options we wouldn't have gone ahead with the birth, not in the way we did,'' Mrs Waller said from her home in Kangaroo Valley yesterday.

''Had things been done right, Keeden would never have been here. He would never have to go through the suffering he goes through – the seizures and all.''

The case raises a number of legal questions and could set a precedent for other parents whose children have disabilities.

The Wallers told Dr James about Lawrence's blood clotting condition, and they claim he breached his duty of care to them by failing to take proper steps to find out whether it could be passed on by just one parent.

In the first day of the hearing yesterday, Justice John Hislop heard that Dr James did not seek to find out the answer himself, but handed the couple the name and phone number of a genetic counsellor at Wollongong Hospital on a post-it note. It is alleged the note was given to the Wallers in the context of a discussion about fertility not genetics, and that the phone number was the main switchboard for the hospital rather than the counsellor's direct line.

When the phone went unanswered the Wallers did not call back, and it is alleged that Dr James did not mention the genetic counsellor again, and began the IVF process.

''There was a duty of care on the part of Dr James to ensure that both he and the Wallers understood that this problem could be passed on and for there to be proper counselling and discussion about the other options they had, including the option of an anonymous sperm donor,'' counsel for the Wallers, David Higgs, SC, said.

It is not the first time the Wallers have been to court in relation to their son. In 2006, they launched an unsuccessful ''wrongful life'' case in the High Court on Keeden's behalf, in which he sought compensation for future loss of earnings and opportunity.

Lawyers for Dr James will argue it is not the responsibility of an IVF specialist to find out whether rare genetic conditions such as antithrombin deficiency can be passed on from father to son.

They claim that such responsibility as does exist was met by the referral of the Wallers to the genetic counsellor.

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IVF doctor faces $10 million 'wrongful birth' case

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Tackling infertility with Chinese herbal medicine

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Does acupuncture boost IVF success?

The study was extremely large following one-thousand two
hundred and sixty Chinese women who were undergoing their first
IVF who were free of endometriosis and PCOS. The women were
divided into two groups: those who had diminished ovarian
reserve (FSH>10 IU/L) comprising one hundred and eighty
seven women and those with normal ovarian reserve. All women
underwent the same IVF protocol.

In women with poor ovarian reserve a testosterone level greater
than 47.85 ng/dl was able to predict pregnancy outcome (with a
sensitivity of 52.8% and specificity of 65.3%). Day three
testosterone was correlated with the numbers of mature
follicles on the day of the hCG trigger and also indicated the
total number of days of gonadotropin stimulation and the total
dose of gonadotropins that would be required. The study
concluded that:

“In women with diminished ovarian reserve, basal T
(testosterone) level was a predictor for the number of large
follicles on HCG day and pregnancy outcome; but could not in
those with normal serum FSH.”

“Basal T (testosterone) levels were associated with both days
of stimulation and total dose of gonadotropins, indicating that
lower level of T might relate with potential ovarian poor
response.”

Interestingly there have been recent studies showing that women
with poor ovarian reserve who receive a pre-treatment phase of
testosterone and DHEA (another androgen) have better IVF
success rates. Your day three testosterone, if low, may
indicate that you may benefit from some form of androgen
pre-treatment to help your IVF to be more successful. The study
further concludes that:

“Basal T level is a good predictor for pregnancy outcome and
number of large follicles on HCG day in women with diminished
ovarian reserve. Basal T level is equally helpful in tailoring
the dosage of gonadotropins to individual and identifying
potential poor ovarian responders, subsequently, making
individualized COH (controlled ovarian hyperstimulation)
strategy before entering IVF cycles. It also gives evidence to
androgen supplementation in infertile women. Those women with
lower basal T (testosterone) levels would benefit from T
supplementation during COH such as improving response,
decreasing the amount of gonadotropins used and the cost
accordingly.”

Your doctor will usually evaluate your FSH (follicle
stimulating hormone) and estradiol on day three to assess
ovarian reserve before IVF, asking for a testosterone test too
could help to fine-tune your IVF for greater success.

1. Association of basal serum testosterone levels with ovarian
response and in vitro fertilization outcome
Qin, Yingying1; Zhao, Zhiyi1; Sun, Mei1; Geng, Ling1; Che, Li2;
Chen, Zi-Jiang1
Reproductive Biology and Endocrinology 2011, 9:9
ISSN:?1477-7827, DOI:?10.1186/1477-7827-9-9

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Day 3 Testosterone May Predict IVF Outcome

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Boston IVF pioneers world’s first needle-free saliva test used in infertility treatment

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Boston IVF Pioneers World's First Needle-Free Saliva Test Used in Infertility Treatment; Patient Friendly Monitoring …

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Study hopes to make IVF more effective

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Mother 'too fat for IVF' dropped five dress sizes and fell pregnant

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New Technique Could Give Child Three Biological Parents

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Why employers should consider paying for IVF treatments

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IVF treatment – Infertility a Serious Problem Report – CNEB 14th Jan 2011 Dr. Manika Khanna2 – Video

www.youtube.com/watch?v=VCfp1HN_J08

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IVF Treatment at UAB Medicine – Video