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Advancing Towards Baby Making

DNA fingerprinting will revolutionise the practice of IVF and eliminate multiple pregnancies.

Given a choice, Gita Kapoor, a 37-year-old banker in Bangalore, would have preferred just one child. She and her software engineer husband knew that with their busy work schedules raising even one child wouldn’t be an easy job. Two years ago, they opted for in vitro fertilisation (IVF) at a fertility clinic in their city. Today the Kapoors are proud parents of a pair of chubby twins — a boy and a girl.

It isn’t that the Kapoors are not happy to have more than one child. But they have two children not by choice but because of an inherent shortcoming in the assisted reproduction technique they opted for.

“So far there is no technique available to choose a single, viable embryo for implantation,” says Dr Trichnopoly Chelvaraj Anand Kumar, a veteran andrologist in Bangalore.

As a result, fertility doctors normally implant more than one embryo to increase the chances of pregnancy. “With a single embryo, the success rate of IVF is about 30 to 35 per cent. It goes up to 45 per cent with two embryos,” says Dr Indira Hinduja, who is the first Indian doctor to have produced a test tube baby in India in the 1980s.

There are a number of problems associated with multiple pregnancies. Often, babies born in a multiple birth are premature, have low birth weight and are prone to infections. Also, their mortality rate is slightly on the higher side, notes Dr Hinduja.

But thanks to a team of medical researchers in Australia and Greece, doctors may soon be able to find a way of successfully employing genetic screening to identify embryos that can lead to healthy babies.

In a paper reported in the latest issue of the journal Human Reproduction, the researchers say that DNA fingerprinting, a technique more commonly used in forensic applications and in resolving parenthood controversies, can be a useful tool in fertility clinics. The technique can help pinpoint a handful of genes that can help spot a better embryo that would lead to a successful pregnancy, says Gayle Jones, a researcher at Monash Immunology and Stem Cell Laboratories, Monash University, Australia.

When a couple attends a fertility clinic for IVF, eggs from the woman are fertilised with sperm from the man and the fertilised eggs are allowed to develop in the laboratory until they reach what doctors call the blastocyst phase, or the early stages of embryo formation. This normally takes about five days.

One of the difficult decisions, even for a better-trained fertility expert, is to decide which fertilised egg is to be chosen. With little help from technology to distinguish a viable blastocyst from a non-viable one, they often resort to implanting more than one to increase the chances. This often leads to multiple pregnancy.

But this need not be the case anymore, say researchers at Monash University and the Centre for Human Reproduction at Genesis Athens Hospital in Greece.

For their study, the scientists removed a few cells each from the outermost layer of the resulting blastocysts of 48 women who attended the clinic for IVF treatment.

Of the 48 women, 25 became pregnant, leading to the delivery of 37 babies. Once the babies were born, blood from the umbilical cords or swabs of cheek cells was collected. Subsequently, the scientists used DNA fingerprinting to see which genes were common to the material collected after delivery as well as the blastocyst biopsy.

“By analysing these genes, we have been able to identify those that are key to the processes involved in embryo implantation,” Jones told KnowHow.

Though it is too early, she thinks that they would be in a position to refine the gene set further to a smaller number of genes that are more highly predictive of a viable blastocyst. “The ability to select a single, most viable embryo from a cohort available for transfer will revolutionise the practice of IVF, not only improving pregnancy rates but also eliminating multiple pregnancies and the attendant complications,” Jones said.

The Monash University researchers hope that the technique would be available for clinical use within a couple of years if they achieve further success.

IVF being the most common and cheapest of all assisted reproductive methods in use, such improvements in its success rate will be a boon to a large number of infertile couples, says Dr Kumar.

Sources:The Telegraph (Kolkata, India)

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Acupunture

Acupuncture

 Acupuncture is a component of traditional Chinese medicine that originated in China over 5,000 years ago. It is based on the belief that living beings have a vital energy, called “qi”, that circulates through twelve invisible energy lines known as meridians on the body. Each meridian is associated with a different organ system. An imbalance in the flow of qi throughout a meridian  is how disease begins. Acupuncturists insert needles into specified points along meridian lines to influence the restore balance to the flow of qi. There are over 1,000 acupuncture points on the body

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Traditional Chinese medicine states that health is dependent on energy. If this energy flow is disrupted by infection, pain or anxiety then physical symptoms are triggered. By inserting fine, solid needles into these channels, the flow of energy – and the patient’s health – is restored.

As these channels are not mappable according to conventional western ideas of anatomy, acupuncture is sometimes considered unscientific. However, studies show it can trigger the release of endorphins – the body’s natural painkillers – as well as stimulate some nerve fibres that block pain. In skilled hands, acupuncture is safe and relatively painless. Most practitioners recommend six to eight treatments. Western medicine accepts its benefits for relief of pain-related conditions, such back problems and migraines, but it is also commonly used for other ailments, such as sinus and bladder conditions. A practitioner should be registered with the local health authority.

There are specific points best avoided in pregnancy although acupuncture is effective for morning sickness. It is often cited as helping people to quit smoking, and though there is little consistent evidence, withdrawal symptoms from other harder drugs may be lessened. More controversially, a report earlier this year in the British Medical Journal reported that women treated with acupuncture could increase IVF success by 65%.

In 1997, acupuncture needles were reclassified from “experimental” to “medical device” by the U.S. Food and Drug Administration (FDA). The National Institutes of Health released a consensus statment in the same year endorsing acupuncture for the treatment of a variety of conditions such as post-operative pain, tennis elbow, and carpal tunnel syndrome.

Acupuncture is one of the best known of the alternative therapies. The FDA estimates that people in the United States spend more than $500 million annually on acupuncture treatments. Many people have insurance coverage for acupuncture.There are numerous theories about how acupuncture works. Some of them are:

*acupuncture stimulates the release of pain-relieving endorphins
*acupuncture influences the release of neurotransmitters, substances that transmit nerve impulses to the brain
*acupuncture influences the autonomic nervous system
*acupuncture stimulates circulation
*acupuncture influences the electrical currents of the body

*It relieves migraines and tension headaches
Resources:

http://altmedicine.about.com/cs/treatmentsad/a/acupuncture.htm?utm_term=what%20is%20acupuncture&utm_content=p1-main-1-title&utm_medium=sem&utm_source=msn&utm_campaign=adid-c0830049-61b6-4bdd-a4ae-5c8fe1422f7f-0-ab_mse_ocode-29597&ad=semD&an=msn_s&am=exact&q=what%20is%20acupuncture&dqi=&o=29597&l=sem&qsrc=999&askid=c0830049-61b6-4bdd-a4ae-5c8fe1422f7f-0-ab_mse

TIMESONLINE:11Th. May”08

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