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Fresh or frozen? A timely IVF debate — Are infertility levels on the rise among US males?

Are freshly retrieved eggs more likely to yield a successful outcome in an IVF cycle than their frozen counterparts? Should genetic screening be performed for diseases that affect 0.8% of the population? Are infertility rates on the rise?

 

These are a few of the topics which were hotly debated at the three-day medical conference held jointly by the European Society of Human Reproduction and Embryology and the American Society for Reproductive Health in Manhattan last week.  These two organizations, of which Rabbi Yitzchok Melber (founder of Tahareinu) is a member, are internationally recognized as the leaders in the field of reproductive medicine.  Rabbi Melber joined the thousands of doctors who flocked from all over the world to share new research, discuss medical breakthroughs and debate treatment options.

 

Cutting edge information was presented on the use of stem cells in reproduction and neurological disease.  These highly advanced treatments are starting to be approved by the FDA and have been implemented in several countries to prevent severe neurological conditions from being passed down genetically.

 

Along similar lines, the concept of genetic screening for diseases affecting less than 1% of the population was debated.  Companies are pushing to make more screening available and standardized, demonstrating how decoding DNA can avoid serious health complications.  Doctors are hesitant to recommend testing where there is no particular cause for concern as it can put people into difficult situations with tough ethical decisions to make.  One groundbreaking form of genetic screening, however, promises to change the lives of women.  Approximately 10% of women of childbearing age suffer from endometriosis, a severely painful condition with many repercussions, often including infertility.  Diagnosis is complicated as the affected tissue is hard to detect by ultrasound.  A simple blood test can now replace invasive procedures by examining genetic variables to determine the probability of the presence of endometriosis and other conditions than impact fertility.

 

Scientists are continually working to refine the IVF process, which currently has a success rate of 40%.  ‘Old-school’ thinking was that freshly retrieved eggs are more likely to be successful as the freezing process could be damaging.  However, recent research has shown that during the retrieval cycle, the uterine lining is less suited to implantation and the chances may be higher if a transfer is only performed in a later cycle when the uterine lining is at its optimum.  Waiting between retrieval and transfer can also prevent the dangerous condition of Ovarian HyperStimulation Syndrome from developing.  There are cases when using freshly retrieved eggs will be beneficial, and therefore, each couple must take individual advice.

 

Male infertility is rising at a rate of 1% each year worldwide.  Out of the 47,000,000 couples of childbearing age in the USA, 15% experience infertility, with 4,000,000 (60%) undergoing IVF each year.  ICSI (IntraCytoplasmic Sperm Injection) is a more advanced form of IVF, developed for cases where good quality sperm is in short supply.  More couples are opting for ICSI as the procedure has a higher success rate, yet is no different for the patient.  However, where there is no male issue, ICSI will not necessarily be more effective, and couples need to, therefore, consider whether it’s worth spending the extra money.

 

Research and medical developments are moving at an astonishing pace, with breakthroughs revolutionizing conventional treatment each year.  Tahareinu makes it a priority to send representatives to conferences of this calibre several times a year; bringing new solutions and treatment options based on the latest innovations from around the world to the frum community.