Babies on ice

Freezing eggs and test-tube conception is a marvel of high-tech wizardry, but it carries loads of hidden risks, and there are safer and more natural ways to overcome miscarriage or infertility

The only thing that the single girl used to ask for on ice was a Smirnoff, but if Dr Gillian Lockwood has her way, it will also be a batch of her potential future children. Lockwood, based at the Midland Fertility Services in Aldridge, near Birmingham, is so passionate an advocate of storing your eggs in a deep-freeze facility like hers as a future fertility ‘insurance policy’ that egg freezing, in her view, should be “every dad’s graduation present to his daughter”.

‘Social freezing’, as it’s known, and ‘ice babies’ prompted a flurry of headlines last November after a Buenos Aires couple in their 40s, who’d suffered multiple failed attempts at in vitro fertilization (IVF), finally gave birth to twins from eggs stored for a record 12 years.

Press and medical interest also got ramped up by a report recently released by the American Society for Reproductive Medicine (ASRM) concluding that egg-freezing is no longer an experimental technology and so is urging young women to freeze their eggs by age 30 in case they don’t find Mr Right early enough to conceive naturally.¹ The latest evidence, it claims, shows similar implantation and pregnancy rates with IVF whether the eggs are fresh or frozen.

Addressing the American Society for Reproductive Medicine’s conference in San Diego last October, Dr Kate Devine, from the US National Institutes of Health, said that egg-freezing represents the future for today’s professional woman-the 30-year-old lawyer, say, who knows she’ll be 40 by the time she has the time and space in her diary to have children.

“So long as you freeze your eggs before 35,” Devine announced, “you have a 75 per cent chance of having a live birth.”

Lockwood even suggests they’re an improvement on the original. “Some say they’re like garden peas,” she says, “that they are actually fresher after they have been frozen.”

But behind the gushing public-relations exercise and the optimistic percentages being bandied about lie far darker statistics not only about egg-freezing, but also other aspects of assisted reproductive technology (ART). There’s no doubt that test-tube conception is a miracle of high-tech wizardry, but like so much of modern medicine, IVF drugs and procedures whether using fresh or frozen eggs have been adopted incautiously by enthusiastic fertility specialists with only a tacit assumption of safety and very little in the way of monitoring of long-term effects in either mother or baby.

Although Louise Brown, the first test-tube baby, resulted from the reimplantation of a single fertilized egg, test-tube-baby pioneers Patrick Steptoe and Professor Bob Edwards soon came up with the idea of improving what was ordinarily a low success rate by implanting more than one egg at a time.

Since that time, fertility specialists carrying out conventional IVF essentially seize control of a woman’s entire fertility cycle, offering a series of powerful drugs first to postpone ovulation and then to kick-start and ramp it up so that more than one egg is produced at one go (see The IVF assault course featured below). With an estimated one in seven couples considered infertile, IVF has become the first port of call for the childless with very little regard for whether all the state-of-the-art drugs or procedures hold any risks.

Staying mum about the perils
What doctors don’t tell you is that whether used as an insurance policy or to overcome infertility, IVF as conventionally practised carries a higher risk of future cancer or death for the mother and birth defects for her child.

In fact, the shocking truth is that during conventional IVF your chances are only 20 per cent that you will have healthy eggs implanted in you.

WDDTY’s special investigation has discovered the following sobering statistics about IVF.

FACT: Four out of five eggs harvested after a woman has undergone heavy-duty hyperovulation procedures may have chromosomal defects, making it more likely that a greater percentage of these ‘rotten eggs’ will be fertilized and reimplanted.²

To examine whether the drugs used to stimulate ovaries for IVF affect the quality of the eggs reimplanted, researchers at University Medical Center Utrecht in the Netherlands split a group of 111 women diagnosed as infertile into two groups, randomly assigning them to the conventional high-dose treatment or ‘mild’ IVF, using shorter courses of drugs (see The IVF assault course featured below).

When the researchers analyzed the results halfway through the study, they discovered that among the nine eggs on average harvested after conventional IVF hyperstimulation techniques, only 1.8 of them (or 20 per cent) were chromosomally normal.

Although mild IVF using far less-invasive drugs (see The IVF assault course featured below) produced the same average percentage of healthy eggs (1.8), as only four eggs on average had been harvested, this represented a far higher proportion (45 per cent) that were chromosomally sound.

Given this surprise finding the Dutch researchers terminated the study early, concluding that the conventional drugs used to hyperstimulate ovaries may be causing mitotic segregation errors (mistakes during cell division) and that mild stimulation might mean “reduced interference with ovarian physiology”.

Robert Jansen, the medical director of Sydney IVF in Australia, said the stronger drugs may cause eggs to develop too quickly and result in “more immature eggs, which are likely to lose chromosomes in the process”.

FACT: Nearly one in 10 babies conceived by ART has major birth defects. Researchers in Britain and Australia comparing the health of 1,200 babies found those conceived with ART were more than twice as likely as naturally conceived infants to have major birth defects diagnosed during the first year of life. The defects ranged from holes in the heart or missing kidneys to brain abnormalities and cleft palates.

In a later review of 25 studies, two-thirds showed a 25 per cent or more increased risk of birth defects in infants born through ART.Overall, the risk of such defects was 30-40 per cent higher compared with spontaneous conception.³

Another 2005 University of Western Australia review of studies of single births from IVF found that perinatal mortality, low-birth-weight and preterm-birth rates were doubled, and that IVF babies had a 50 per cent increase in rates of small for gestational age and up to a 30-35 per cent increase in birth defects compared with single births conceived naturally.⁴

FACT: Women undergoing IVF pregnancy may have four times the risk of death from pregnancy than they would ordinarily.⁵

According to Dutch research, the most comprehensive investigation of maternal mortality linked to IVF to date, 49 of every 100,000 women died from IVF or an IVF pregnancy, compared with 12 of every 100,000 ordinary pregnancies.

In the UK, although four times as many abortions than IVF cycles were carried out in 2007, there were nearly four times as many deaths related to IVF.

Extrapolating from the Dutch figures, the researchers concluded that IVF- related mortality is underreported worldwide.⁶

Deaths occur mainly due to either the risks of multiple pregnancy or ovarian hyperstimulation syndrome (OHSS), a potentially life-threatening medical problem, causing severe accumulation of fluid in the abdomen and chest, and even in the sac surrounding the heart.

FACT: Women undergoing IVF and hyperstimulation through fertility drugs have three and a half times the risk of developing invasive ovarian cancer after 15 years.The Netherlands Cancer Institute in Amsterdam studied a nationwide group of nearly 20,000 women who’d received IVF treatment between 1983 and 1995. After following them for n
early 15 years, the researchers found that the risk of ovarian cancer in the IVF group was three and a half times higher than normal. Overall, both ovarian tumours and malignancies were more than four times higher with IVF. ⁷

FACT: Although the American authorities claim no difference between fertilization and survival rates between thawed and fresh eggs, the entire process may damage eggs. With the slow-freezing method, ice crystals can form within the egg, causing the egg to burst. Vitrification, the latest and more successful technique, gets round this problem by flash-freezing the eggs in a bath of antifreeze before placing them in liquid nitrogen tanks at -193^0 F.

During thawing, the egg must be warmed quickly and immediately removed from the antifreeze, a chemical brew some specialists worry could damage the egg. Some studies of the survival rates of eggs with the new methods show rates of pregnancy comparable to those of IVF, but don’t examine the quality of the eggs. According to Chinese research examining 600 thawed eggs, although most eggs survived the vitrification process, 18 per cent of those had chromosomal problems. After fertilization, only 42 per cent of the embryos were of high quality and only 33 per cent of blastocysts (the early dividing embryo) developed properly.

In Italian research (one of the only studies to reveal the actual number of healthy babies resulting from IVF), of 1,087 eggs harvested from 289 patients, then frozen and thawed, 760 survived, 687 were injected with sperm, 368 produced a normally developing embryo, 331 were transferred back into the women, and of these, 18 pregnancies resulted, ending with six miscarriages and 13 healthy children (one a set of twins).

That translates into a take-home-baby success rate of just 4 per cent.⁸

Natural assistance
If all these risks concern you and you’ve tried and failed to have a child, you can explore other, safer alternatives. Doctors have had success with either ‘natural’ or mild IVF that uses no or fewer drugs, or by simply improving the health of the woman and her partner before they even attempt a pregnancy.

A preconceptual care programme developed by the British charity Foresight more than 30 years ago has now been used by thousands of ‘infertile’ couples to achieve what they never thought possible-to conceive and become parents naturally.

The charity, begun in 1978 by former nursery nurse Nim Barnes, bases its approach on the idea that fertility in both men and women is a moveable feast largely affected at any point in time by the individual’s current nutritional status and toxic environmental load, including chemicals of any sort, heavy metals, infections (including parasites), allergies and ‘voluntary social poisons’ (like caffeine, cigarettes and alcohol). Couples seeking help from Foresight are urged to clean up their acts months before attempting to conceive.

Foresight practitioners ask couples to fill out a questionnaire and undergo a number of tests (hair-mineral analysis, blood and sweat tests) for the presence of parasites and to determine levels of certain nutrients (like zinc or magnesium) and heavy-metal toxicity, then design an individual programme around the specific needs of each couple, including advice on diet and lifestyle, suggested nutritional supplements and treatment for parasites, among other suggestions.

Although Foresight’s approach has not been subjected to rigorous scientific study, ample published research shows that dietary status and environmental pollutants do affect fertility (see The IVF assault course featured below). And the results of the charity’s own survey of some 2,000 couples is compelling. They report an 89.8 per cent success rate in 1,578 couples who completed the full Foresight programme-and that’s not just live births, but healthy babies born. There were 42 miscarriages (2.96 per cent; the national rate for the general population is an estimated 25 per cent) and only two of the single births were premature. Of 518 couples who completed only part of the programme, the success rate was 69.1 per cent and the miscarriage rate was 7.53 per cent.

As many couples go to Foresight as a last resort, these results are impressive. In fact, the survey revealed that responders had a total of 3,004 failed IVF attempts, 2,383 failed IUI (intrauterine insemination, where sperm is placed inside the womb) attempts, 1,081 failed ICSI (intracytoplasmic sperm injection, where a single sperm is injected directly into an egg) attempts and 8,939 miscarriages before contacting the charity.

Foresight’s first medical advisor Dr Patrick Kingsley, a former GP and a specialist in nutritional and environmental medicine, believes the charity’s approach works (and his many patients who have used it testify to its success) because it mirrors his own highly successful holistic approach to healthcare in general.

“I don’t see preconceptual care as any different from cancer, MS or arthritis, in that you have to identify what is wrong with both potential parents,” he says. “Diet plays an important part as well as specific nutrients, depending on what you find in the history.”

If a woman is tired all the time, for example, an early-morning temperature test in the armpit could help identify whether she is thyroid-deficient, says Kingsley, in which case iodine would be worth trying. And if a man has white spots on his fingernails or stretch marks on his skin, he’s deficient in zinc so zinc supplements would be helpful.

Based on his experience, Kingsley has found that fertility problems can often be helped by simply avoiding certain foods, chemical additives and drugs-like sugar, animal milks and products, alcohol, caffeine and aspartame-which is in line with what Foresight recommends as part of its fertility programme (see Using foresight to get pregnant featured below).

You can try some of these steps yourself to get your fertility back on track, but it may be better to work with a qualified practitioner who can determine if you’re deficient in any nutrients and diagnose any other potential problems.

If you’ve cleaned up your diet, taken supplements and eliminated the toxins from your life and you’re still not pregnant, you may wish to try ‘natural’ or mild IVF, where the doctor still harvests your eggs and fertilizes them outside of your body, but doesn’t subject you to any-or so many-fertility drugs ee The IVF assault course featured below).

The IVF assault course
In vitro fertilization (IVF) refers to any situation where an egg is fertilized by sperm outside of the body. With conventional IVF, which uses eggs from the mother and sperm from her partner, doctors give the woman drugs to stimulate her ovaries to produce multiple eggs. These eggs are then removed through a guided technique such as ultrasound. A sample of semen is gathered from the partner and used to fertilize the eggs in a laboratory dish. Up to three of the resultant healthy embryos are then transferred to the woman’s womb on the (unproven) grounds that the more that are allowed to develop, the greater the likelihood that one will make it to term.

Pharmaceutical stimulation of the ovary is now the central plank of conventional assisted reproduction, where the doctor basically seizes control of a woman’s entire fertility cycle and then keeps careful watch over the size of the follicles in the ovaries (where the eggs develop) and hormone levels to ensure they don’t mature too quickly.

Women undergoing IVF are usually given three types of drugs:

• gonadotrophin-releasing hormone (GnRH) agonists or antagonists to suppress the release of luteinizing hormone from the pituitary gland and stave off ovulation until the follicles are mature. This essentially brings on a state of temporary menopause.

• follicle-stimulating hormone (FSH) to juice up the ovaries into pumping out as many mature eggs as possible.

• human chorionic gonadotropin (hCG) to help mature the eggs in the follicle
  s.

• ‘pituitary down-regulation’ to postpone ovulation via goserelin acetate and sometimes yet more hormone drugs. This kind of heavy-duty tinkering of a woman’s reproductive cycle is responsible for many of the dangers to mother and child described in the main story.

Besides the full monty, there are other types of IVF that still use a test-tube for conception, but make use of either no drugs or smaller-supposedly safer-amounts of drugs that may be a better alternative.

• Natural cycle IVF involves collecting and fertilizing the one egg a woman releases during her normal monthly cycle without the use of drugs. According to the Human Fertilisation and Embryology Authority (HFEA), the live-birth rate for this type of IVF is around 1.3 per cent per natural cycle for women aged between 40-42 years. This category also includes ‘modified natural IVF’, a term coined and described by Geeta Nargund, medical director of Create Health Clinics, which controls ovulation by giving women a single dose of indomethacin (a non-steroidal anti-inflammatory painkiller), to interfere with prostaglandin and so delay ovulation; this is then followed by an hCG ‘trigger shot’, which kick-starts the ovaries again into producing a number of eggs. While this approach makes use of fewer and less dangerous drugs (avoiding the risk of overstimulated ovaries), it again makes certain assumptions about safety, as both drugs are known to cause birth defects in children when taken during pregnancy.

• Mild IVF, where a woman gets considerably lower doses of fertility drugs like FSH and gonadotropins and is also given them for a shorter period of time compared with conventional IVF. This lowers the risks of suffering the worst side-effects of the drugs. For natural and mild fertility treatments, see www.createhealth.com.

Using Foresight to get pregnant
As a nursery nurse, babies were already a big part of Nim Barnes’s life, but it was after experiencing some serious health issues with her own children that Nim started to look into the importance of taking care of your health before you start trying to conceive.

Nim began researching optimal pregnancy conditions by meeting or corresponding with leading doctors and researchers around the world, including Carl Pfeiffer, whose Brain BioCenter in Princeton University pioneered the use of nutritional supplements to aid mental illness, Derek Pryce-Smith of Reading University, who studied the effect of environmental toxins like lead, and Canadian biochemist Abraham Hoffer, one of the pioneers of orthomolecular medicine (the use of nutrients to treat illness).

With the help of numerous UK doctors like Patrick Kingsley, Marilyn Glenville and Neil Ward, who set up and ran a testing facility for her at Surrey University, Foresight was born. Now in its 35th year, the Foresight programme has not only helped couples have healthy babies, but has also succeeded in giving thousands of ‘infertile’ couples the chance to become parents naturally-in many cases, where conventional medicine has failed.

Here are eight essentials of the Foresight plan:

• Eat well. A healthy body is needed to produce a healthy baby, so follow a varied whole-food diet with high-quality proteins, no refined carbohydrates and plenty of fresh vegetables and fruits. Stick to organic produce and drink filtered water to minimize exposure to pesticides and other potentially harmful chemicals.

• Supplement to correct any nutritional deficiencies. A study by Dr Stephen Davies of the Biolab Medical Unit in London showed that magnesium deficiency is associated with female infertility, increased miscarriage rates, and increased incidences of premature and low-birth-weight babies. When magnesium supplements were given over four monthsto six magnesium-deficient women with unexplained infertility, all six conceived within the following eight months and produced healthy babies.⁹ In men, low levels of zinc have been linked to poor sperm quality and infertility.¹⁰
• Stop smoking. Research shows that the more cigarettes a woman smokes, the less likely she is to conceive. Smoking has a negative impact on male fertility too.¹¹

• Avoid alcohol, as even moderate drinking (five or fewer drinks per week) can contribute to infertility in women.¹²

• Cut the caffeine. Found in coffee, tea, cola and chocolate as well as in over-the-counter drugs, caffeine can slash your chances of getting pregnant. In one study, women who consumed a cup of coffee or more a day were half as likely to become pregnant, per cycle, as women who drank less than that.¹³

• Get tested for infections. Genital infection is a major cause of infertility worldwide. Chlamydia trachomatis infections are the most common. Left untreated, they can lead to salpingitis (inflammation of the fallopian tubes), ectopic pregnancy and infertility. Parasitic and fungal infections can also contribute to infertility.¹⁴

• Investigate allergies. Food allergies may play a role in infertility. In one case study, an ‘infertile’ woman was found to have an allergy to gluten (coeliac disease). Eight months after being put on a gluten-free diet, she conceived.¹⁵

• Minimize your exposure to environmental chemicals such as pesticides, plastics chemicals and heavy metals like lead, mercury and cadmium, as they can affect fertility.¹⁶ See our detox feature for more information.

• For the full fertility programme as well as details on any tests you might need and where to get them, contact:

Foresight
www.foresight-preconception.org.uk
Telephone: 01275 878 953
3 Lower Queens Road
Clevedon
North Somerset
BS21 6LX

More natural helpers

• Bee propolis. One study suggests that supplementing with the sticky stuff made by bees from plant resins (500 mg twice a day for nine months) could treble your chances of getting pregnant if you suffer from endometriosis.¹⁷

• Vitamin C may be useful if you suffer from luteal phase defect (LPD), a hormonal abnormality or imbalance. Taking 750 mg/day of the vitamin for up to six months more than doubled the pregnancy rate in a group of sufferers-to 25 per cent.¹⁸

• Multivitamins. By taking one simple multivitamin as a daily supplement, a group of women took 5 per cent less time to conceive than those taking a placebo. ¹⁹

• L-Arginine (16 g/day) can improve fertilization rates in women with a history of failed IVF attempts. The amino acid can also improve sperm counts and sperm motility in men, as can carnitine, zinc, selenium and vitamin B12.²⁰

• Agnus castus. Thirty drops twice a day of this herbal remedy for three months may help you conceive, as it did in one group of ‘infertile’ women. ²¹

• Acupuncture. Six months of acupuncture plus moxibustion and herbal medicine helped nearly two-thirds of women with unexplained infertility conceive. ²²

SPECIAL REPORT

Sanchia Silver, 33:
“Thanks to Foresight I have a beautiful, healthy little girl”

After over a year of trying for a baby with no success, my partner and I were diagnosed with “unexplained infertility”. We were advised that our only hope was IVF but to keep trying in the meantime.

More than another year passed and I did in fact fall pregnant naturally. We were thrilled. At the 20-week scan, however, we were given the heartbreaking news that our baby had severe bilateral ventriculomegaly [abnormally enlarged ventricles in the brain] and talipes [club foot] and was unlikely to survive to term. If he did, he would likely be severely physically and mentally disabled. We made the devastating decision to have a termination.

I was not convinced that this was just ‘bad luck’, as we were told by all the medics we encountered. While trawling the web
looking for answers, I stumbled across the Foresight website and their philosophy struck a chord with me. I got in touch immediately and pestered my boyfriend to let me chop off chunks of his hair to send off for analysis.

We discovered that both of us were deficient in numerous minerals and also suffering from elevated levels of toxins.

We embarked on a hefty supplement programme, ditched alcohol and caffeine, and were advised to resend hair samples for analysis in 12 weeks’ time. Each time we got the results back we could see the numbers creeping in the right direction and felt a tiny surge of hope that one day I might fall pregnant again and have a healthy baby.

Neither of us was expecting anything to happen for months or even years, so when my period was late I didn’t take a pregnancy test straightaway. When I finally did and it was positive, we couldn’t quite believe it! We’d been on the programme for seven months and had only been trying for a baby again for the last two.

On 22 December 2010 we welcomed our beautiful, perfect little girl Seren into the world, weighing in at a healthy 7 lb 6 oz.

Ellie Parkes, 41:
“After four miscarriages, five IUI attempts and three tries at IVF, I finally have the family of my dreams”

My husband and I had been trying for a baby for two years before we decided to see a consultant. We were prescribed the fertility drug Clomid, but when nothing came of that we went for various tests and were told we had “unexplained infertility”. I didn’t know whether this was good or bad: good because there was nothing specific wrong with us, but bad because we couldn’t address a particular problem.

We were advised to try intrauterine insemination (IUI), which involves placing sperm inside the womb. Although the first attempt failed, in May 2005 I discovered I was pregnant! We were so happy, but our hopes were dashed at the seven-week scan when I was told there was no heartbeat. It was devastating.

After three more failed IUI attempts, we decided to go down the IVF route. To our delight, it worked! We went on to have a beautiful baby girl in August 2007.

We were so blessed and fortunate to have her, but I desperately wanted a brother or sister for her, so we tried to conceive naturally for the next couple of years.

It came as no surprise that I didn’t get pregnant. We decided to give IVF another go, but our first attempt failed. We were just preparing ourselves for another attempt when I found out I was pregnant naturally! It was fantastic. But we got an enormous shock when I lost the baby at 12 weeks, leaving me utterly bereft.

Amazingly, I got pregnant a few months later, but again miscarried early on. The same thing happened when I got pregnant through IVF in December 2010; I miscarried at about nine weeks.

Soon after, a friend suggested I try the Foresight programme. I thought I might as well give it a go. It wasn’t invasive and even if I didn’t get pregnant, I’d still be full of energy and vitality after taking all the nutritional supplements.

My husband and I signed up for it and started following the regime to the letter. I was a bit disappointed that we had to wait eight months before we could start trying for a baby again, but when we did I got pregnant straightaway! I went on to give birth to a wonderful, healthy baby boy in September 2012.

Foresight vs IVF
Of 1,578 couples who completed the full Foresight programme, 89.8 per cent produced live, healthy babies and only 2.96 per cent miscarried. Currently, the most optimistic average success rate for IVF is 21.3 per cent, and the national miscarriage rate is an estimated 25 per cent.

Nearly one in 10 IVF babies has birth defects; in the Foresight sampling, there were none.

Lynne McTaggart and Joanna Evans

Vol 23 no 10 January 2013

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