Tuesday, January 04, 2011

Soya-based fertility treatment may cut miscarriages and boost pregnancy up to six-fold

Yesterday is was green vegetables that were the miracle cure. What next? The figures as reported are impressive, however, so there may be something in it. Note that the patients all had apparent problems so we may simply be seeing here the correction of a nutritional deficiency -- something that might not generalize to other women

An experimental fertility treatment increases the odds of an IVF pregnancy up to six times while also inhibiting chemicals which cause miscarriages, a study has found. When women who had gone through IVF time and time again without success were given a soya-based substance, half became pregnant. In contrast, fewer than one in ten of those who had conventional fertility treatment alone conceived.

The doctors behind the remarkable study believe that the Intralipid liquid, a fat and calorie-rich potion normally used when tube-feeding very sick patients, could help many more women achieve their dream of motherhood.

Improving success rates would spare women the emotional and financial pain of going through repeated IVF treatments, only for them to fail. The liquid also stems the production by the body of harmful chemicals which can lead to miscarriage.

George Ndukwe, of the Care fertility clinic in Nottingham, said: ‘Every day in my clinic I see women who have had numerous IVF cycles all with the same negative outcome and no baby. ‘I also regularly see couples who have suffered the misery of repeated miscarriages. ‘People talk about the financial implications but the emotional one is as bad or, I would say, worse. ‘These women are at the bottom of a dark pit and can’t climb out and can’t see the light. We are devoting our attention to finding answers when nature goes wrong.’

Dr Ndukwe, the clinic’s medical director, believes that up to one in four women who struggle conceiving have faulty immune systems.

It is thought that extra high levels of white blood cells called natural killer cells ‘fight’ the pregnancy by triggering the production of chemicals that attack the placenta or the embryo.

The chemicals are already known to trigger rheumatoid arthritis and the arthritis drug Humira has shown promise in boosting pregnancy rates. However, it costs up to £2,000 per patient and does not work for everyone.

At around £200 per woman, Intralipid, which is given through a drip around a week before a woman has IVF, is much cheaper.

And the latest research, to be presented at a British Fertility Society conference on Thursday, shows it is also more effective at stemming production of the harmful chemicals.

Dr Ndukwe said: ‘This infusion is inexpensive, well tolerated and easy to administer.’

The fertility expert ran his trial on a group of women who had failed to become pregnant despite enduring an average of six IVF attempts each. One woman had tried and failed at IVF 12 times. Half of those treated became pregnant, compared with just 9 per cent of those not given the fatty substance.

Other doctors are trying to use steroids to lower levels of natural killer cells in the body. Professor Siobhan Quenby, of Solihull Hospital and Warwick University, has already successfully used an asthma drug to curb the immune system response in a pilot trial of women who had suffered repeated miscarriages.


An implant to alleviate arthritis

Good if the implant lasts over time

Chris Blundell is ­consultant orthopaedic surgeon at the ­Northern General Hospital, Sheffield. He says:

The big toes take about 70 per cent of the body’s weight, so there are enormous ­pressures acting on a relatively small joint. It is, ­therefore, not surprising that there are high rates of wear and tear, and osteoarthritis in this area as people get older.

The pain often leads to patients walking or moving ­differently, which puts extra stress and strain on other joints, such as the knee.

It can also lead to a more ­sedentary lifestyle, which can place sufferers at risk of weight gain and cardiovascular disease.

The current treatment for severe osteoarthritis of the big toe is arthrodesis, or fusion, in which we insert a metal strip into the joint between the two bones and fuse the bones together with screws so that they no longer rub against each other. This is usually ­performed on younger people.

Although fusions do get rid of the pain, the toe is permanently rigid and no longer bends at the joint. In older people, osteoarthritis can be treated on occasions by removing the toe joint altogether.

This new toe implant, made by the American company Carticept, ­provides a new surface in the joint to stop the ends of the bones rubbing. It is circular, about the size of a large pill, and made of hydrogel, the substance used in ­contact lenses, which is 60 per cent water and 40 per cent polymer.

The material is designed to have flexibility similar to that of human cartilage, and is strong enough to withstand the load put on the joint. It’s a relatively new material and is being looked at for use in other joints.

The big advantage over fusion is that the implant preserves the joint, which means that the toe can be bent. The procedure takes about 30 minutes.

First, an inch-long incision is made above the joint, so the ends of both bones are exposed. The end of the bone that ­connects the toe to the foot is then drilled to create a small pocket so that we can insert the implant. Because it is similar to cartilage, it cushions the joint on both sides.

Once the implant is in place, the incision is stitched and the patient goes home.

We are one of four hospitals in the UK which are carrying out these procedures as part of a research study. About 12 people in the UK have had the operation so far.


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