Advice on adjuvants

Patients are often overwhelmed by the range of optional treatments some fertility specialists offer. These treatments are not part of the standard IVF treatment and are often referred to as adjuvants. Unfortunately, many of these treatments cost a lot of extra money, are not proven to work and may expose the patient or her unborn baby to unnecessary risk.

For that reason, the Human Fertilisation and Embryology Authority, which oversees the licensing of IVF units in the UK, has now released a very helpful patient information sheet that can help patients decide which adjuvants are effective and safe to use.

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Flushing tubes helps

Radiologists need special liquids to inject in the uterus and the tubes to make them stand out on an X-ray.  A study recently published in the prestigious journal New England Journal of Medicine shows that flushing the Fallopian tubes with an oil-based contrast medium leads to much higher pregnancy rates following the X-ray than a water-based contrast medium. 

The lead investigator of the study, Professor Ben Mol, announced the results at the World Congress of Endometriosis held in Vancouver this week.

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Professor Ben Mol and Professor Luk Rombauts at the World Congress of Endometriosis in Vancouver

Professor Ben Mol and Professor Luk Rombauts at the World Congress of Endometriosis in Vancouver

How many eggs should I freeze?

A large IVF unit in the US has used its extensive database to calculate how many eggs women should freeze to have a reasonable chance of a having a live birth when they return to use the eggs later.

The figure below illustrates by how much the chance of a live birth rate increases with the number of frozen eggs that are available. That chance declines with a woman's age. The highest chance is achieved when using donor eggs (usually from young fertile egg donors).

Source: Human Reproduction, Vol.32, No.4 pp. 853–859, 2017

Source: Human Reproduction, Vol.32, No.4 pp. 853–859, 2017

Don't skip your flu shots!

Can flu shots help women get pregnant? That is the question being discussed in the top journal Science this week. Professor Sarah Robertson, a world expert on immunology in reproduction from the University of Adelaide, is excited. She has previously warned that the indiscriminate use of corticosteroids in IVF is unsafe and ineffective but she can see how the flu shots may deliver on two fronts: protecting women against the flu and improving their chances to get pregnant.

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Careful with corticosteroids!

Yesterday the Sydney Morning Herald picked up on an article By Prof Sarah Robertson, Australia's most eminent reproductive immunologist. In her article Prof Robertson warns against the use of corticosteroids such as prednisolone in IVF. There is virtually no evidence that corticosteroids improve live birth rates but we know they are associated with significant risks.

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