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#$%$&^%^*&(^&%&$ - Sisyphus Shrugged
Lasciate ogni speranza and put your feet up.
jmhm
jmhm
#$%$&^%^*&(^&%&$
sz features the touching story of the Vests, who "adopted" some of the "snowflake babies" Our Fearless Leader was so excited about last week. If you haven't been following this little expedition into the warmfuzzies by the hard men of the Republican far right, women are being encouraged (unless they're lesbians, because there are some things more important than Life) to "adopt" frozen embryos from fertility clinics to be implanted in their own wombs. The federal government has spent $2 million dollars encouraging this since 2002.

Our Fearless Leader held a photo op with a snowflake baby on the day that the House slapped him down over stem cell research. See, one of the objections that many people have to his stance on this is that while he believes that a fertilized ovum is in fact a human being and entitled to all the rights and privileges of a human being (it's a culture of life thing), he has not done anything about the IVF industry, which is responsible for the destruction, through freezing, improper storage and just flat disposal, of hundreds of thousands of these little people-with-a-right-to-life every year.



Isn't that touching?

Did I mention that we've spent two million dollars encouraging more women to undergo IVF procedures?

So what exactly have we spent two million dollars encouraging?
After the eggs are retrieved
The eggs are then fertilized in the laboratory with her partner's sperm. If the sperm is very poor, the ICSI procedure may be needed in order to fertilize the eggs.

The embryos are cultured in the laboratory for 2-6 days. Assisted hatching is a procedure that might be done on the day of the embryo transfer in selected cases. It has been shown to improve the chances for pregnancy when applied properly in certain circumstances.

the embryo transfer procedure is done which places the embryos in the woman's uterus where they will hopefully implant and develop to result in a live birth. This is like a Pap smear for the woman. There should be no discomfort.

If there are leftover embryos (of sufficient quality) beyond the number that is transferred, many couples prefer to have them frozen (cryopreserved) for use in a future cycle. Embryo cryopreservation can be used for another attempt at having a baby if the "fresh" cycle fails - or as an attempt to have another child if the fresh cycle is successful.

What are the Pregnancy rates?
According to 1997 statistics, the success rate of IVF is 22.8% live births per egg retrieval. This success rate is similar to the 20% chance that a healthy, reproductively normal couple has of achieving a pregnancy that results in a live born baby in any given month. Women under 35, without male factor, who try IVF, have on average a 25% chance of conceiving and having a baby. Some clinics achieve even better results. Success with IVF increases with the number of cycles attempted up to four cycles. Of the 78% of pregnancies as a result of IVF that result in a live birth, about 50% are singletons, 24% are twins and 5% are triplets or more. The CDC (see link below) continues to release new data yearly.

So seven out of ten attempts at IVF result in dead embryos.

Not every embryo is implanted, though.
Egg retrieval under ultrasound guidance and subsequent fertilization and embryo culture are carried out according to our current procedures. If there happens to be a surplus of embryos following selection for fresh transfer (usually between one to four embryos are transferred to the uterus), then embryos of sufficient quality may be considered for cryostorage. While embryos can be frozen at any preimplantation stage between one-cell (one day old) to the blastocyst stage (5-6 days old), in an attempt to minimize the freezing of excessive numbers of "spare" embryos and to help pre-select the most potentially viable embryos, we generally choose to cryopreserve only at the blastocyst stage. In certain cases where all embryos need to be frozen without a fresh transfer (e.g., when a woman may be at risk from ovarian hyperstimulation that might be complicated by pregnancy), we generally freeze all embryos the day after egg collection at the one-cell stage.

Techniques of controlled-rate freezing are utilized that slowly cool embryos in cryoprotectant fluid ("anti-freeze" solution) from body temperature down to -196°C, at which temperature they are stored in containers of liquid nitrogen called dewars. The embryos are actually contained within special indelibly labeled plastic vials, or straws, that are sealed prior to freezing. Once frozen, they are placed inside labeled tubes attached to aluminum canes and stored in numbered canisters within the liquid nitrogen dewar. Site and label designations are stored in three separate file systems to avoid confusion and misidentification of cryopreserved embryos. When it comes time to thaw the embryos, all available identifiers of the stored specimen must match and be confirmed before thawing commences. The embryos are thawed out at room temperature, which takes about one to two minutes. However, the most critical element of the thaw procedure is not the timing but the careful dilution of the cryoprotectant fluid to return the embryo to its favored culture medium. This permits resumed growth and development in vitro. Once this is done, the embryo is assessed for cryodamage to determine if it is suitable for transfer. Experience has shown that if the embryo survives 50% or more intact, it is worthwhile to replace it. Embryos can accommodate such levels of cellular damage and still establish healthy pregnancies. All thawed embryos routinely undergo assisted hatching prior to transfer. The zona pellucida, which surrounds the embryo, has been shown to suffer a certain amount of hardening during cryopreservation. This can be overcome by artificially making an opening in the outer embryo shell.

Varying strategies may be applied according to how many and which embryos are thawed prior to transfer. It should be noted that not every couple undergoing IVF will need to worry about embryo freezing/thawing, since not every couple will have sufficiently large number of "surplus" or non-transferred embryos available for freezing. Indeed, most couples have only one or two embryos frozen, so that all are thawed and any surviving are replaced. In the event that there are more than two or three embryos frozen, thawing is usually undertaken until two to three healthy appearing embryos are recovered. In some cases, this may mean that all the cryopreserved embryos are thawed, in others just two or three. There always remains a possibility that there may be no embryo survival after thaw occurs, and no transfer is possible. If many early embryos are frozen, it is possible to thaw all of them and culture them for several days to allow selection of the best for transfer. When too many embryos are available for transfer in this circumstance, then extra embryos of sufficient quality may be refrozen for later use. This course of action has produced healthy offspring, proving the efficacy of double freezing of embryos.

...

The primary concern with the use of cryopreservation techniques is the possible loss of embryos to cryoinjury, meaning some healthy embryos may not survive the stress of freezing & thawing. The exact number of embryos lost to cryoinjury varies, but it is very likely that freezing will cause loss of some embryos, perhaps as many as 25-50% of those cryostored. One interpretation of this is that cryopreservation may even act as a "selection gate" for the more viable embryos, though this has never been proven.

Another concern with cryopreservation is the potential risk of birth defects in children produced from frozen/thawed embryos. In the domestic animal industry, large-scale freezing and transfer of embryos has not resulted in increased birth defects. Studies to date on those human offspring arising from thawed embryos have not shown any significant increase in abnormalities when compared to pregnancy outcomes in the rest of the population.

There are said to be 400,000 frozen embryos waiting to be defrosted in this country. Apparently they're Schroedinger's Babies.

I wouldn't worry too much about the risk of birth defects, though, because, well, those babies just don't happen
There are many different medical, social, economic or cultural circumstances which put couples under the most intense pressure to produce a child of a specific gender. Scientists have identified thousands of health problems where genes play a part and many gender-related medical disorders can be passed from parent to child.

Pre-Implantation Genetic Diagnosis (PGD) is a medical procedure which allows embryos to be tested for gender-related genetic conditions, prior to being placed in the womb, giving the best opportunity to select the gender of your baby. PGD involves tried and tested assisted conception techniques which are safe, reliable and ethically sound. In-vitro fertilization is now widely accepted and this forms the basis of our gender selection program.

PGD is beneficial when:

* Either one of a couple carrying a single gene defect, by testing for specific genetic disorders
* Women aged 35+, by testing for age-related chromosomal disorders
* Younger women with repeated unexplained miscarriages, by testing for chromosomal disorders
* Couples wanting to balance their family

That last, by the way, is a delicate way of saying "people who don't want a girl"

So not only are there hundreds of thousands of embryos dying procedurally every year, the remaining embyos are culled eugenically and according to sex, and the "losers" discarded. The pioneering doctor is quite explicit that he's involved in the production for use business, although the fawning article on MSGOP neglected to bring it up. We're talking about large-scale abortions here, and abortions where the woman's body is not even involved.

A shortlist of PGD providers.

There are those who believe that there's another problem with IVF - it may not work any better than the other available fertility methods
In vitro fertilization can improve pregnancy rates among couples with unexplained infertility, but there is little evidence to show whether IVF results in more live births than other treatments, according to a new review of recent studies.

Although expensive and invasive, IVF is a widely used treatment, despite potential complications, including a multiple pregnancy rate of about 25 percent.

According to the analysis by Dr. Zabeena Pandian of the University of Aberdeen, Scotland, and colleagues, the rate of babies born from IVF procedures is not significantly different from the rate of live births from artificial insemination and a procedure called gamete intrafallopian transfer.

The review appears in the April issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“There is insufficient evidence at present to suggest that IVF is more effective than the other treatment options available for unexplained infertility,” Pandian and colleagues conclude.

However, pregnancy rates were significantly higher with IVF than with “watchful waiting” and with IVF compared to gamete intrafallopian transfer, or GIFT, the researchers found. In one study comparing IVF with no treatment, 20 of 68 women receiving IVF became pregnant, while only one of 71 women were pregnant after three months of no treatment. In two studies comparing IVF with GIFT treatment, 39 of 84 women became pregnant with IVF, compared with 24 out of 85 women with GIFT.

The researchers note, however, that the studies in the review were small and varied considerably in their quality, definitions of unexplained infertility and follow-up periods.

“Until more evidence is available, IVF may not be the preferred first line of treatment for these [infertile] couples and it might be appropriate to continue with less invasive options,” Pandian says.

IVF is a process in which egg and sperm are joined to produce an embryo in the laboratory before the embryo is implanted in a woman's uterus. In GIFT, egg and sperm are mixed in the laboratory and inserted in a woman's fallopian tubes before the formation of an embryo. Artificial insemination involves placing a specially prepared semen sample directly into a woman's uterus during ovulation.

IVF has become a widely accepted treatment for unexplained infertility even though very few high quality studies comparing infertility treatments exist, according to Pandian.

“IVF is becoming popular when there is no specific explanation for infertility as it may be able to overcome a variety of problems,” she says. “However, it is expensive, complicated and can have many adverse effects, including multiple births.”

The researchers found no significant differences in multiple pregnancy rates between IVF and intrauterine insemination, but there was a higher rate of multiple births in IVF recipients compared to those who received GIFT.

They bring up multiple births because in traditional IVF, where more than one egg was implanted to increase the possibility of pregnancy, the multiple birthrate skyrockets. Here in the US, though, cutting-edge IVF technology has come up with an answer: let that little ball of undifferentiated cells develop into a little ball of differentiated cells and pick the best ones (three guesses what the consolation prize for the losers is).

Back to the snowflake babies (you knew we were coming back to them, right?)

Rep. Pence of Indiana had this to say as he rode the snowflake babies around the talkshow circuit
It is "morally wrong to take the tax dollars of millions of pro-life Americans and use it to support research that they find morally offensive," Republican Representative Mike Pence from Indiana told the NewsHour.

Did I mention that we've spent two million dollars encouraging people to undergo this procedure since 2002?
ahhhs. -- hmmm?
Comments
canonfire From: canonfire Date: May 28th, 2005 05:30 pm (UTC) (linkie thing)
PGD sure does sound like eugenics to me.
jmhm From: jmhm Date: May 28th, 2005 05:33 pm (UTC) (linkie thing)
In our ally-who-shares-our-culture-of-life England, it's now legal to use it to pick the embryo which has the cells most likely to be of use to someone in the family who needs cells for something.

In our ally-who-shares-our-culture-of-life Australia, Medicaid pays for it (as well as three tries at IVF).

They've had great success with it in our ally-who-shares-our-culture-of-life Saudi Arabia.
temima From: temima Date: May 29th, 2005 05:28 am (UTC) (linkie thing)
(Once more with closed braces)

On another note, why does the phrase 'snowflake baby' strike me as stupid?

While according to the Catholic Library article on Evangelium Vitae tells of specific condemnation of "procedures that exploit living human embryos and fetuses--sometimes specifically "produced" for this purpose by in vitro fertilization--either to be used as "biological material" or as providers of organs or tissue for transplants in the treatment of certain diseases." I imagine that they would condemn sex-selection disposal of embryos. However, there is nothing specific about the disposal of embryos as a matter of course for IVF treatments.

(One piece of counter data point: I do remember a controversy about a New York Post copy editor named Dawn Eden inserting a mention of discarding the 'leftovers' in an article about IVF. She got fired for it. One religious rightish blog covering it supported her. The comments actually talked about the ethics of disposal. First time I ever saw it discussed in those circles)
jmhm From: jmhm Date: May 29th, 2005 05:36 am (UTC) (linkie thing)
suffice it to say that if the late Pope whose "culture of life" Our Fearless Leader has hijacked had heard it applied to encouraging in vitro fertilization he would have been somewhat upset.
ahhhs. -- hmmm?