Waterstone Clinic is continuing to lead the way in bringing ground-breaking technologies and fertility treatments to Irish families, with the announcement of the birth of the first baby after pre-implantation genetic screening (PGS) in Ireland.

PGS is a complex form of IVF treatment which is recommended for couples who have experienced recurrent miscarriages or repeated unsuccessful IVF cycles. Screening embryos for genetic defects before transferring them significantly increases the chance of a successful pregnancy and decreases the chance of miscarriage. It also considerably reduces the chance of having a baby with genetic problems.

A significant proportion of human embryos which develop normally in the IVF lab have genetic defects and are unable to produce a normal successful pregnancy. The most common abnormality is aneuploidy where one too many chromosomes or one too few are present in all of the embryo’s cells.

Most embryos with chromosome abnormalities will not implant or will result in miscarriage during the first trimester of pregnancy. PGS can improve the potential for a successful pregnancy by ensuring that chromosomally normal embryos are transferred.

With PGS, embryos are generated using a form of IVF treatment known as intracytoplasmic sperm injection (ICSI). They are then screened to find out if they have the correct number of chromosomes. Embryos with a normal number of chromosomes are then transferred into the woman’s uterus.

PGS can be recommended in the following situations:

• Recurrent miscarriages in the past
• Repeated unsuccessful cycles of IVF where embryos have been transferred
• Advanced female age (it is well-recognised that the risk of aneuploidy increases with increasing maternal age)
• Family history of chromosome problems

What is involved for the couple?

If a couple embark on PGS treatment the following is the usual sequence of events in their care:

Step 1. The couple undergo IVF treatment with ICSI employed to fertilise each of the oocytes collected

Step 2. The embryos are kept in culture until Day 5/6 (Blastocyst stage)

Step 3. The embryologist biopsies the embryo (in the process removing a number of cells from the embryo) and these cells are sent to the genetics laboratory for testing

Step 4. The biopsied embryos are cryopreserved until the results of the chromosomal analysis is available

Step 5. One or two of the embryos that appear chromosomally normal are transferred to the uterus

A successful PGS programme is only possible if the laboratory team involved can carry out all of the component processes flawlessly, i.e. blastocyst culture, embryo biopsy and embryo vitrification.

What are the risks with PGS?

• The embryos may not develop appropriately to the stage where they are suitable for biopsy
• There is a risk that all biopsied embryos will be aneuploid and result in no suitable embryos for transfer
• There is a risk that some embryos may not survive the biopsy process
• There are risks associated with IVF treatment itself such as ovarian hyperstimulation syndrome or pelvic infection

 A couple are celebrating the birth of a child after using a new embryonic screening technique.

The baby is the first to be born in Ireland using the technique, which offers hope to women who have had repeated miscarriages or have gone through several unsuccessful cycles of IVF treatment.

The baby girl was born at Cork University Maternity Hospital two weeks ago, after the couple underwent successful preimplantation genetic screening (PGS) with IVF treatment at the Waterstone Clinic earlier this year.

Dr John Waterstone, medical director of the Waterstone Clinic,said: “This breakthrough will provide vital information to thousands of Irish couples who have endured multiple miscarriages, or failed IVF treatments.”

Dr Waterstone said that 20 per cent of pregnancies result in miscarriage and in most cases no explanation is ever found.

“However, research indicates that at least 50 per cent of miscarriages are caused by chromosome abnormalities.

“This uncertainty is particularly upsetting for couples who have suffered recurrent miscarriage.

“Around one in every hundred women will have recurrent miscarriages.”

Dr Waterstone explained that PGS is different to preimplantation genetic diagnosis (PGD), which has been used by clients of the clinic to avoid having babies with certain genetic conditions such as cystic fibrosis, sickle-cell disease and muscular dystrophy.

He said that PGDis the screening of embryos for a specific genetic condition so that parents at risk of passing on the condition to their children can avoid doing so.

The PGD process involves generating a number of embryos through IVF and then examining the genes of these embryos.

An embryo that is free from the genetic condition is then selected and transferred to the woman’s uterus.

Chromosomes

Dr Waterstone said that, in contrast, PGS involves examining IVF-generated embryos to see if they have the correct number and structure of chromosomes.

“An embryo with the normal structure and number of chromosomes will be selected and transferred to the woman’s uterus.

“This significantly increases the chance of a successful pregnancy and reduces the risk of miscarriage,” he said.

Dr Waterstone explained that the child’s mother and her partner were recommended for the treatment after a number of unsuccessful cycles of IVF treatment at the clinic.

“We are all delighted that PGS has helped this couple to become parents. PGS is a significant development that provides real information to couples who have endured the heartbreak of repeated miscarriages, or failed IVF cycles, without getting any answers.

“Through PGS, we can provide an extra level of information on the true potential of an embryo.”

© 2015 irishtimes.com

Barry Roche

http://www.irishtimes.com/news/ireland/irish-news/first-baby-is-born-in-ireland-using-new-ivf-technique-1.2424501

A Cork woman has become the first in Ireland to give birth following a complex new IVF treatment at a leading fertility clinic. The healthy baby girl was born last week at Cork University Maternity Hospital, following Pre-Implantation Genetic Screening with IVF at Waterstone Clinic.

The 33 year old mother and her partner were recommended PGS treatment following a number of unsuccessful IVF cycles. The woman was the first to give birth as a result of PGS carried out in Ireland.

Pre-implantation Genetic Screening (PGS) is a technically challenging IVF treatment that involves screening embryos for chromosome abnormalities, before transferring them to a woman’s womb. PGS significantly increases the chance of having a successful pregnancy after embryo transfer. It also decreases the chance of miscarriage and, considerably reduces the chance of having a baby with a chromosome anomaly.

This breakthrough will provide vital information to thousands of Irish couples who have endured multiple miscarriages, or failed IVF treatments.

Miscarriage affects one pregnancy in five and in most cases no explanation is found. However, research indicates that at least 50% of miscarriages are caused by chromosome abnormalities.

This uncertainty is particularly upsetting for couples who have suffered recurrent miscarriage. Around one in every hundred women will have recurrent miscarriages.

Welcoming the news of the birth, Dr John Waterstone, Medical Director of Waterstone Clinic, said: “We are all delighted that PGS has helped this couple to become parents. PGS is a significant development that provides real information to couples who have endured the heartbreak of repeated miscarriages, or failed IVF cycles, without getting any answers. Through PGS, we can provide an extra level of information on the true potential of an embryo. “

What is PGS? 

PGS is a highly complex form of IVF treatment where embryos which are developing normally in culture are biopsied and cryo-preserved (by vitrification) at the blastocyst stage. The biopsied cells are analysed to determine if they are normal with regard to chromosome number and structure.

This process identifies chromosomally normal embryos which are suitable for transfer. A successful PGS programme is only possible if the laboratory team involved can carry out all of the component processes flawlessly, i.e. blastocyst culture, embryo biopsy and embryo vitrification.

PGS is recommended for couples who have experienced recurrent miscarriages, or repeated cycles of unsuccessful IVF treatment. It is also recommended for women in their 40s with good egg numbers.

The healthy baby girl was born last week at Cork University Maternity Hospital. The woman and her partner were recommended Pre-Implantation Genetic Screening (PGS) with IVF at Waterstone Clinic following a number of unsuccessful IVF cycles.

PSG involves screening embryos for chromosome abnormalities before transplantation.

The technique significantly increases the chance of a successful pregnancy after embryo transfer and also decreases the chance of miscarriage.

Miscarriage affects one pregnancy in five and while in most cases no explanation is found, research indicates that at least 50% of miscarriages are caused by chromosome abnormalities.

Speaking on RTÉ’s Morning Ireland, Medical Director of Waterstone Clinic Dr John Waterstone said Irish couples have always availed of genetic screening procedures, but have had to go abroad in the past.

Dr Waterstone said the latest procedure was carried out for a couple who were not at risk for a genetic disease but were desperate for a baby.

He said in this case seven embryos were tested and five proved to have chromosomal abnormalities.

He said the other two were normal and one embryo was transplanted resulting in a successful pregnancy.

Three other babies have been born as a result of Pre-Implantation Genetic Diagnosis carried out at the centre, including a baby girl born last year whose parents underwent PGD to prevent her from inheriting cystic fibrosis.

http://www.rte.ie/news/2015/1110/740787-cork-birth-ivf/

A Cork woman has become the first in Ireland to welcome a baby after undergoing a new complex IVF treatment.

The mother (33) gave birth to a healthy baby girl two weeks ago in Cork University Maternity Hospital following Pre-Implantation Genetic Screening with IVF at Waterstone Clinic.

The complex new procedure was recommended to the woman and her partner following several failed attempts at IVF.

The ground breaking procedure involves screening embryos for chromosome abnormalities before they are transferred to the womb.

The procedure significantly increases the chance of successful implantation and pregnancy in the aftermath of the procedure and decreases the chance of miscarriage. The procedure also reduces the chance of giving birth to a baby with chromosome abnormalities.

The success of the procedure is expected to offer hope to many couples struggling with multiple miscarriages and failed IVF treatments.

Following the arrival of the healthy baby girl in Cork, Dr John Waterstone, Medical Director of Waterstone Clinic, said: “We are all delighted that PGS has helped this couple to become parents. PGS is a significant development that provides real information to couples who have endured the heartbreak of repeated miscarriages, or failed IVF cycles, without getting any answers. Through PGS, we can provide an extra level of information on the true potential of an embryo. “

Online Editors

http://www.independent.ie/life/family/mothers-babies/woman-33-welcomes-irelands-first-baby-born-following-groundbreaking-new-ivf-treatment-34185496.html

There is very good reason to be positive about fertility treatment, the medical advances of late have been ground-breaking and success rates are hugely encouraging. But it’s essential to be prepared for the emotional side of the experience and to know that at times, it will take its toll.

Often, women presenting at fertility centres exhibit high levels of stress and anxiety. They can take excellent care of their physical health when trying to conceive, but will often tend to overlook their emotional wellbeing and, it’s not something to be ignored.

It’s good to take a step back and consider your happiness and whether you feel supported during this. Know that it’s ok to feel scared and worried, but really try not to let these feelings overwhelm you – the statistics are hopeful – 55% of patients under the age of 35 that attended Waterstone Clinic for treatment went on to have a baby. 51% aged 35-37 years of age also had a baby.

And research by the American Society for Reproductive Medicine has shown that the vast majority of people undergoing fertility treatment adjust well emotionally, and there seems to be no evidence of a long-term impact on relationships.

Undergoing fertility treatment is, however, a difficult experience and it can be easy to lose sight of your mental wellbeing as you go through numerous tests and procedures.

So, I’ve outlined a few practical steps to take to ensure your mental health is in check:

1. Inform yourself

Information and knowledge are a good antidote to anxiety. The more you know and understand about the process, the less stress you may feel. Arm yourself with all the information available from your fertility centre, ask your doctors for advice on good reading material and, talk to anyone you know who has been through the process. There are also support groups you can join, and fertility centres will always have information on good counsellors.

2. Limit discussion

If you’re going through assisted reproduction with a partner, it’s important to communicate, but set a limit to that communication. Put aside 20 minutes a day to discuss it, and then put the subject off-limits. During this time, talk about your hopes and expectations of each other throughout the experience, like, whether you will you go to appointments together or if you need them to be with you when the doctor calls. You can do this with a close friend or confidante if you are opting for fertility treatment as a single person.

3. Know your stress response

Identify your stress triggers and get familiar with how you and your partner respond to stress. Anticipate what is going to make you or your partner most stressed during the process, will it be fitting in the appointments at the clinic or maybe it could be the injections. Become aware of each other’s style of dealing with stress and figure out what has helped in the past. This will help to develop your coping strategies. Women usually find they want to talk it out and they need verbal support while men tend to want to spend time doing something they enjoy, like a hobby or activity. Knowing in advance how you and your partner are likely to react, will make it easier to be supportive and more understanding of each other.

4. Minimise confidantes

Decide in advance who you will tell about the process. It can be a good idea to identify who’ll give you the support you’re going to need and only confide in those people. You can also nominate a ‘spokesperson’ who will communicate what is going on to your wider circle of family and friends, if and when you want them to. With hindsight, a lot of patients can feel they would have been under less pressure if they hadn’t told so many people.

It’s important to think about these coping mechanisms in advance to minimise the stress and anxiety associated with fertility treatment. Additional support and advice will always be available from professional counsellors at your fertility centre, while joining a support group, or even attending a few meetings is always helpful.

Remember, the statistics are favourable and the more positive and relaxed you are, the better for your overall health and the health of your future baby.

Because We Control Contraception, Doesn’t Mean We Can Control Conception

Anton Savage from Today FM speaks with CFC’s Mary McAuliffe about raising awareness of the link between age and fertility, especially amongst men and women in their twenties.

Listen to the interview here:

http://www.todayfm.com/player/podcasts/The_Anton_Savage_Show/The_Anton_Savage_Show/43505/0/mary_mcauliffe__fertility_nurse_specialist

For further information on My Fertility Check, visit http://myfertilitycheck.ie/

It is 30 years since the first successful frozen egg pregnancy was conceived. For many years, egg freezing was considered to be a low-chance option for fertility preservation, needing 100 eggs to get one live birth.

For young women with cancer who were facing the near-inevitable sterility of chemotherapy or radiotherapy, the prospect of freezing their eggs, with even a low chance of genetic motherhood in the future was acceptable. The human egg, the largest cell in the body, is a tiny fluid-filled bubble and, during freezing, icecrystals form that can damage the delicate structures inside. The introduction of egg “anti-freeze”, vitrification (flash-freezing) and sperm micro-injection (ICSI) improved success rates.

Donor eggs are seen as the obvious solution for many women with age-related sub-fertility, but many would still prefer their own genetic child. Fertility clinics now have frozen egg banks where young, vitrified, eggs are available to match any racial or physical characteristic required by the recipients. Pregnancy rates from these frozen donor eggs, obtained from young women, are the same as those from fresh egg-donation cycles (50-70% per cycle).

This success has led to increased takeup of “social” egg-freezing because women want the opportunity to become a mother in a supportive, long-term relationship.

The decision by Facebook and Apple to offer social egg-freezing to female employees has reignited the debate about whether egg-freezing represents the ultimate type of family planning for today’s professional woman, or whether the prospect of having frozen assets really does offer the opportunity to safely defer and delay motherhood until the right time or the perfect partner arrives.

Unfortunately, the majority of women choosing to freeze their eggs have already left it too late to have a realistic chance of achieving a live birth from a single cycle of egg freezing. Just as with fresh eggs, successful pregnancies are more likely to be obtained using frozen young eggs.

The circumstances in which women choose to freeze eggs often reflect their social situation, in which they have either not found a partner who wishes to parent with them, or a long-term relationship that they assumed was heading towards parenthood has failed. It is unfair and unfortunate that at 38 (the modal age at which UK women seek egg freezing), she has two years to realistically achieve a healthy pregnancy whereas her similarly-aged partner has two decades.

Women seeking social egg-freezing are significantly committed to the conventional ideal family structure and regard single parenthood via the use of donor sperm as a poor last resort. By freezing their eggs they may believe they have bought a little biological time and the costs and small risks associated with the procedure may well be worth taking for that sense of empowerment.

However, at the present level of efficacy of oocyte freezing, it is vital that women, especially if they are over 35, are made aware that their frozen eggs do not represent an insurance policy against childlessness.

Source: Gillian Lockwood is medical director of the Midlands Fertility Centre

http://www.theguardian.com/society/2015/oct/24/social-egg-freezing-empowering-but-not-an-insurance-policy-against-childlessness

The advent of successful Pre-Implantation Genetic Diagnosis has been very encouraging for people at risk of passing on debilitating genetic conditions. PGD is an advanced fertility treatment which enables couples, who are at known risk of a specific genetic condition, to avoid passing it on to their children. The couple conceive by means of IVF treatment and embryos selected by the process are genetically tested, before being transferred to the woman’s womb.

Recently, a healthy baby girl was born in Cork, free from the life-limiting genetic disorder Smith Lemli Opitz Syndrome, after undergoing PGD at Waterstone Clinic. The girl’s parents were both carriers of the gene mutation concerned and became aware of this when their first child died as a result of Smith Lemli Opitz. When both parents are carriers for this and, other similar genetic disorders, there is a 25% chance that any child will be affected.

The rare disorder is caused by a mutation in the gene that codes for the enzyme involved in cholesterol production. Cholesterol is an essential component of all cells and so an affected person will have problems with many different organs. This was the first instance in Ireland of two people who are carriers of Smith-Lemli-Opitz Syndrome successfully using PGD to prevent it being transmitted to their child.

This is the third healthy baby born as a result of PGD at Waterstone Clinic. In April of this year, baby Megan O’Connor was the first reported case in the world of a baby born free from the rare genetic condition mucolipidosis, after PGD using Karyomapping. In July 2014, Bridget Belle Cooke was born free from cystic fibrosis, after her parents underwent PGD treatment at Waterstone Clinic. Bridget’s father has cystic fibrosis and her mother is a carrier for the disease.

The ground-breaking technique has been very successful to date. 46% of couples treated using the complex technique at Waterstone Clinic have gone on to have a baby. PGD however is expensive and the cost is prohibitive for some couples.

In the UK, clinics licenced to carry out PGD can apply for funding for a couple needing the treatment, provided they meet the appropriate medical criteria. There is no reason why we could not have a similar programme in Ireland.

Preventing the inheritance of conditions like cystic fibrosis and muscular dystrophy would not only ease the pain and suffering of many children, but would also help reduce the spend on future healthcare services.

It is my sincere hope that the new government will take steps towards providing financial assistance for couples at risk of passing on genetic disorders who would benefit from PGD treatment.

Dr. John Waterstone

Matt Cooper discusses a new test that can double IVF success rates to over 80% with Prof. Dagan Wells from Reprogenetics, Oxford, UK. This test could be hugely beneficial for would-be parents who often face multiple disappointments and considerable expense going through repeated IVF treatment cycles.

Listen back to the interview, (minute 17):

http://www.todayfm.com/player/shows/The_Last_Word_with_Matt_Cooper/7/24118/20th_October_2015_-_The_Last_Word_with_Matt_Cooper_Part_3