IVF spreading rapidly in Muslim world
IVF centres have opened up in nearly 20 nations in the Middle East, taking advantage of a ban on legal adoption in Muslim countries in the region. Medical anthropologist Dr Marcia Inhorn told the ESHRE conference that Sunnis and Shi'ites have different attitudes towards ART. Sunni fatwas have allowed IVF and intracytoplasmic sperm injection (ICSI) so long as a couple's own gametes are used. Eggs or sperm from someone else would be regarded as adultery. Shi'ite leaders, on the other hand, have permitted donor egg technologies and, under certain conditions, even donor sperm. ~ ESHRE press release, Jul 1  

Ban cloning, not embryo stem cell research, says ESHRE
Research on embryonic stem cells must continue even if adult stem cells prove to be the only types useful for clinical purposes, says the new president of ESHRE, Professor Arne Sunde, of University Hospital in Trondheim, Norway. "We think there is large potential for the use of embryonic stem cells in the future," he told a news conference. "We are not there yet, We may be a decade away from it." ~ ABC (Madrid), Jul 2; Reuters, Jun 30

Although it supports "therapeutic cloning", ESHRE has sternly disassociated itself from human reproductive cloning, describing it as unsafe and "totally irresponsible as well as unethical". Its outgoing president, Professor Hans Evers, also expressed his concern at the public relations damage suffered by ART and embryonic stem cell research because of reckless attempts to produce cloned babies. ~ ESHRE press release, Jun 29

At the same time, in a move which undercuts the official ESHRE position, an ethicist working for its US counterpart, the American Society for Reproductive Medicine, John A. Robertson, published a letter in the leading journal Nature which criticises a hasty ban on cloning. "If human reproductive cloning becomes safe, protecting the welfare of cloned persons... will cease to be a strong reason to oppose reproductive cloning." He called for "a much finer-grained policy analysis". ~ Nature, Jul 3  

Perplexing study reassures IVF parents
A major study of the intelligence of children born through fertility techniques claims that they are not significantly different from their normally conceived peers at five years old. As well, they have similar birth weight and height, are no more likely to have behaviour problems and their parents are no more likely to suffer from high levels of stress.

However, 6.2% of children conceived through ICSI had birth defects, mainly in the urinary and genital systems, the gut, muscles, bones and skin -- compared to 2.4% for naturally conceived children. The comparable figure for children conceived through IVF was 4.1%, but researchers said it was not statistically significant.

Researchers suggested that ICSI may result in a higher number of malformations because the father's sperm likely to be abnormal and in the normal course of events would not result in a birth. It could also be due to the technique itself, which involves injecting the sperm directly into the egg quite near the nucleus.

The confusing mix of good news and bad news arising from the research project, which was conducted by Professor Christina Bergh of Sahlgrenska University Hospital, in Sweden, was reflected in headlines. Focusing on the intelligence and behaviour results, the Reuters banner was "Test tube babies develop like normal kids". Similarly, the BBC wrote "Public reassured on IVF safety". New Scientist, on the other hand, highlighted the alarming incidence of birth defects: "ICSI kids have more malformations". ~ Reuters, Jul 2; New Scientist, Jul 2; BBC, Jul 2  

Womb transplants soon, say Swedish scientists
Healthy, fertile mice have been born from mothers with transplanted wombs, leading Swedish researchers to predict that the same technique will be available to women within three years. Mats Brännström, of Gothenburg University, feels that rejection will be the main problem -- apart from the formidable surgical difficulties. "Potential donors could be the mother or older sister [of the infertile woman] who has had her own babies, or other altruistic donors", he says. It raises the possibility that a daughter might carry a child in the same womb that she developed in. A human womb transplant was carried out in Saudi Arabia in 2000, but it failed after 99 days. ~ New Scientist, Jul 1  

Yuk, cry IVF researchers
A Chicago fertility doctor's attempt to create human embryos with both male and female cells has been condemned as flawed and unacceptable by his colleagues. Dr Norbert Gleicher, of the Foundation for Reproductive Medicine, injected one, two or three cells from male embryos into 21 female embryos. Twelve of them developed normally until they were destroyed at about six days. Gleicher was toying with the notion that the chimeras would be resistant to single gene disorders.

Other IVF scientists were scathing in their remarks. Australia's Professor Alan Trounson described the experiment as "completely flawed". "You can't have half of Huntington's disease," he said. And ESHRE ethicists Dr Francoise Shenfield says that "I cannot conceive of any situation in which this particular technique would be acceptable, and if it cannot be applied there is not much use in experimenting with it." Dr Gleicher agrees that clinical applications appear at the moment to be far-fetched and ethically dubious, but he has still patented the technique and may investigate further. ~ Reuters, Jul 2; New Scientist, Jul 3  

Amniotic fluid may contain potent stem cells
Austrian scientists have detected pluripotent stem cells in the amniotic fluid which cushions a baby in its mother's womb. Markus Henstschläger, of the University of Vienna, says that amniotic fluid "may represent a new source for stem cells without raising the ethical concerns associated with human embryonic research". It is still too early to tell what these cells could become and how fast they could multiply. Preliminary experiments suggest that they could become nerve cells. ~ New Scientist, Jun 30  
   

NZ right-to-die bill attacked by Attorney-General
A proposed bill to allow the terminally ill to kill themselves with the help of a doctor would breach New Zealand's Bill of Rights, says Attorney-General Margaret Wilson. She said that it would violate "the right not to be deprived of life and the right to freedom of expression". She also criticised the bill's provision for appointing a guardian to execute a living will. It did not ensure that a person would understand "the nature of the document he or she signed and the consequences of his or her decision". ~ New Zealand Herald, Jun 27  

US study finds that feeding tubes are overused
A study of 186,000 senile residents in all 15,000 US licensed nursing homes has criticised the growing use of feeding tubes. Writing in the Journal of the American Medical Association, Dr Susan L. Mitchell of the Research and Training Institute of Hebrew Rehabilitation for the Aged in Boston, says that "growing empirical data and expert opinion [indicate] that feeding tube use has no demonstrable health benefits in this population and may be associated with increased risks and discomfort". Her study found that 34% of patients with advanced dementia in 1999 had feeding tubes.

A spokeswoman for the American Health Care Association, which represents many for-profit nursing homes, disputed the study's conclusions. Sandra Fitzler said that each decision to insert a tube needed to be examined individually and that nursing homes did not necessarily make more money out of tube-fed patients.

However, Dr Mitchell said that nursing homes had financial incentives to give feeding tubes to their demented patients. Medicaid paid more for patients on tubes and hand feeding was more costly. Another of her concerns is the fact that blacks and Asians are more likely to have feeding tubes, as are poorer patients in larger nursing homes. ~ New York Times, Jul 2  

"Opt-out" law not enough to shorten organ lists
A policy of "presumed consent" for organ donation is not enough to boost the supply of organs, says a leading Austrian transplant specialist. Austria's "opt-out" law, which permits organs to be harvested after death unless a patient has formally registered a refusal on a central register, has been widely praised. But Professor Ferdinand Muehlbacher, of Vienna's University Hospital, says that in practice, doctors seek the consent of relatives.

In fact, as in other countries, the demand for organs in Austria is outstripping supply. The waiting list for organ transplantation actually grew by 10%, according to 2002 figures. Professor Muehlbacher says that the key to increasing the number of donors is enthusiastic doctors. "You have to motivate the doctors to report a donor," he told Reuters Health. "A young colleague of mind who was keen on improving the supply of donors joined one ICU and doubled the supply in six months." ~ Reuters Health, Jun 26  

Philippines tightens up on kidney trade
The Philippines government has introduced a new law to restrict sales of kidneys to foreigners and to ban payments for organs. Toronto's Globe and Mail reports than there are at least four kidney brokers in Manila and a handful of surgeons who operate on foreigners at two private hospitals.

At the same time, kidney patients are trying to revive a scheme which will allow prisoners to donate their kidneys in exchange for a pardon or to save their lives. They argue that the concept will benefit both donor and recipient. A philosophy professor at the University of the Philippines, Leonardo de Castro, describes it as "a way to atone for past sins, although it has the additional feature of being beneficial to another."

Transplant surgeons oppose the idea of prisoners donating organs. In the 1980s, about 50 maximum-sentence prisoners donated organs in the hope of a cash reward and a reduced sentence. The experience was not a happy one. Only one prisoner served less time and the program ceased in 1990. Some recipients complained that the donors tracked them down after release and tried to extort more money from them. A former director of the National Kidney Institute was also attacked in 1999 and his daughter shot more than a dozen times, a crime attributed to the kidney trade. ~ Globe and Mail, Jun 23