Thursday, 31 July 2008

nhs news - Complications of IVF

“Fears of complications with IVF babies dismissed in new study” is the headline in The Guardian. Research based on 1.2 million births in Norway looked at the babies of women who had conceived once by IVF and once spontaneously. It found little difference between the siblings, and concludes that the risks associated with IVF are likely to be related to existing fertility problems in the parents and not a result of techniques used during assisted fertilisation, the newspaper explains.
The Daily Telegraph also reported some of the results of this study, saying “babies conceived through IVF are much more likely to die at birth”. These results are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies. The newspaper did not directly discuss the implications found in the comparison of IVF and non-IVF siblings.
This large study used complex statistical methods to try to tease out the risks related to the various factors. It is reliable and should be reassuring to women undergoing IVF. However, it is important to note that the risks of complications in an individual birth are in fact quite low (around 1% perinatal deaths in this study).
Where did the story come from? Dr Liv Bente Romundstad from the Department of Obstetrics and Gynaecology at St Olavs University Hospital in Trondheim, and other colleagues from around Norway, UK and France, carried out the research. The study was funded by the Trondheim Hospital and the Norwegian Research Council. It was published in the peer-reviewed medical journal The Lancet.
What kind of scientific study was this? This was a cohort study in which the researchers used data from the Medical Birth Registry of Norway. This has records of more than 2.2 million births, which occurred in Norway between 1967 and 2006. The researchers had information about pregnancy across the population as it had been recorded on standard forms by midwives or doctors within one week of delivery for all deliveries after 16 weeks gestation. This information included details about the mother’s health, antenatal and birth history, and it was linked to the “Statistics Norway” database. The researchers were able to identify outcomes for all the babies, because in Norway each baby is given a unique identification number.
From the data on 1,305,228 births from January 1984 to the end of June 2006, the researchers excluded records where there was missing data on the number of children, or if the mother was less than 20 years old or had had more than six children. Only single babies (not twins or other multiple births) who were born at 22 weeks or later, and weighed 500g or more, were assessed. After this process, they found 1,200,922 births following normal conception and 8,229 after assisted fertilisation.
First, the researchers assessed differences in birthweight, gestational age, and the chances that babies were born small for their gestational age, were born prematurely or died in the period around birth (perinatal death). They analysed the relationships between all these variables, using a model that looked at all mothers as a whole (the whole study population analysis). They also divided the mothers into groups for their year of birth, maternal age, and number of children, and assessed them separately.
"The adverse outcomes of assisted fertilisation ... could therefore be attributable to the factors leading to infertility, rather than to factors related to the reproductive technology." Liv Bente Romundstad, lead author
After this whole study population analysis, the researchers then looked at whether the risks associated with IVF were due to the IVF technique itself or whether they were due to other factors linked to the fertility of the parents. In order to do this, they compared the health of babies born to mothers who had experienced both an assisted fertilisation (IVF) conception and a normalone. There was information for 2,546 Norwegian women available for analysis. These “sibling-relationship comparisons” looked at whether there were differences between the brothers or sisters born to women after both assisted fertilisation and normal conception. The researchers also took into account the order of conception (if IVF occurred before spontaneous conception or the other way around). They adjusted the results for maternal age, number of previous babies, sex of the baby, time between pregnancies and year of delivery.
What were the results of the study? In the whole study population analysis, assisted-fertilisation conceptions were associated with lower average birthweight (a difference of about 25g), shorter duration of gestation (about two days), and an increased risk of babies being too small for their gestational age, or dying in the period around birth.
In the sibling-relationship comparisons, where spontaneously conceived babies were compared with their assisted-fertilisation conceived sibling, there was an average difference of only 9g in birthweight and 0.6 days in gestational age, and these differences were not statistically significant.
There was also no statistically significant difference in the rates of small-for-gestational age births and perinatal mortality when the assisted fertilisation babies were compared with the spontaneous conception babies in the sibling-relationship comparisons.
What interpretations did the researchers draw from these results? The whole study population results, which showed that the risk of adverse events is higher with IVF, are consistent with many other studies looking at the outcome of assisted fertilisation pregnancies compared with spontaneous pregnancies.
However, looking at the babies born to women who had conceived both spontaneously and after assisted fertilisation, there was no difference in birthweight, gestational age, risk of small-for-gestational-age babies, and preterm delivery between siblings.
The researchers conclude that adverse outcomes of assisted fertilisation seen in the general population could therefore be attributable to the factors leading to infertility, rather than to factors related to the IVF technique itself.
What does the NHS Knowledge Service make of this study? This study has successfully compared the outcomes in the babies of individual women who had become pregnant following both assisted (IVF) conception and a normal (spontaneous) conception.
This is a novel approach made possible by the large population-based database. As a large study, it has provided reliable results. Even so, the researchers say that the study was not large enough (powered enough) to study births that occurred before 32 weeks of gestation, or to study the perinatal mortality among women who had conceived both spontaneously and after assisted fertilisation.
It is possible that some of the conceptions were misclassified, i.e. recorded incorrectly, particularly for those women where conception occurred outside of Norway.
Overall, the study confirms that birthweight, gestational age, and risks of small-for-gestational-age infants and preterm delivery did not differ among brothers and sisters born to women who had conceived both spontaneously and after assisted fertilisation. This should provide reassurance to mothers that any adverse effects following assisted fertilisation are more likely to be due to underlying infertility

Wednesday, 30 July 2008

The new Mountain Buggy Urban Double is due August



The New Mountain Buggy Urban Double 2008 buggy has just get even better, the buggy has always been a favorite with mums and dads of twins, it's a roomy yet narrow double buggy at just 74cm wide fits through most doors yet has plenty of space for your growing children.
The new MBUD 2008 is suitable from birth with the multi reclining seats adjusting to near flat and the new model now has an aduster bulit into the harnesh for smaller babies - great from twins! or as with all the range can be used with Mountain Buggy Carry Cots to make a twin pram.
Comes complete with a free Mountain Buggy Twin Storm cover, with it's front opening zip which can be rolled open, large shopping basket with pockets for bottles and keys and phone, a bottle carrier and a Mountain Buggy pump is included in our price.
The short wheelbase makes maneuvering easy, and as its so narrow helps when exiting doorways. The front swivel wheels option is excellent on busy streets & indoors and offers true 'turn the buggy with just one finger' .
By locking the front wheel to the fixed position, the Mountain Buggy Urban Double can handle the park, light jogging & off-road conditions with ease making this an all terrain buggy, and now with rear suspension to give even more comfort. The four large wheels give market leading stability in all conditions for safety, and with an adjustable handlebar to ensure optimum comfort for the parents while pushing.
Turn this buggy into a twin pram with optional carrycots available to suit one or two babies or two toddlers, details of carry cots can be found in our Buggy Accessories.
Mountain Buggy Urban Double 2008 offers -
All purpose High tensile aluminium frame
Upright to fully reclined seat positions
Rear wheel suspension for a smoother ride on any surface

Large storage basket with smaller storage pockets
Suitable from newborn
Quick release wheels
5-point safety harness
Foot operated brake
Easy one-step fold
Sunhood with viewing window
Water resistant, easy cleaning Hardwearing fabric
Full range of accessories
Free air pump and drink bottle holder
Made in New Zealand
Dimensions
Width 74 cms
Fold Size With Wheels 104 x 39.5 x 74 cms
Weight 16 kgs
Mountain Buggy reviews

Should you require further assistance, or wish to place a pre order for the new 2008 Mountain Buggy, please email customerservice@twins-store.co.uk delivery due in August

guardian - The fertility tourists

The fertility tourists
The ads are brazen: 'healthy young women - superovulated exclusively for you!'. The fees are half those of UK clinics ('flights and hotel included!'). And the industry is unregulated, leaving doctors free of legal and ethical constraints. No wonder more and more Europeans are going to India for fertility treatment. Raekha Prasad reports
Raekha Prasad
Wednesday July 30 2008
At the end of last year, Ekaterina Aleksandrova boarded a plane in London and flew to Mumbai. It wasn't her first trip there - she is a management consultant and often goes abroad on business. But this time she went to have five embryos implanted in her womb. A couple of days later she flew back to Europe. While on business in Hong Kong in January, she discovered she was pregnant with just one embryo.
For Aleksandrova, 42, this was the culmination of a six-year struggle to become a mother. She divorced at 29, and hadn't been in a serious relationship since she was 34. "I always wanted to have a child but the men kept saying, 'Why don't we travel?'" she says. "It wasn't that I was obsessed with my career, I just couldn't get men to be a father."
First, she tried to adopt in Germany, where she holds citizenship, but that didn't work out. Then, in 2004, she moved to the UK to take advantage of this country's more liberal attitude to single women who need IVF. She spent £18,000 in less than three years, trying and failing to conceive at a private Harley Street clinic. When she finally conceived in India, Aleksandrova was in a state of "shock and disbelief".
The baby she is due to give birth to in September has no genetic link with Aleksandrova. The colour of its eyes, length of its legs and slope of its nose will be determined by a man and a woman who are strangers not only to her, but also to each other. Her baby's biological parents live 7,000km apart, and are separated by language, culture and currency. All they share is their decision to ply their gametes in the global fertility bazaar where Aleksandrova shopped for the ingredients of life, perusing and eventually paying for eggs and sperm. Aleksandrova bought the sperm online from a Danish sperm bank retailing in New York. The $1,600 (£800) price-tag included shipping to Mumbai, where her Indian doctor helped get the tiny frozen container through customs unscathed. There, the Danish sperm was used to fertilise the fresh eggs of an Indian woman who was paid 40,000 rupees (£500).
Alexsandrova first began surfing foreign fertility clinics' websites in the winter of 2006/7. Impressed with the Indian doctor's responses to her email inquiries, she flew out to Mumbai for a couple of days the following April to investigate further. She then visited the Taj Mahal.
She brought home a Punjabi-style pyjama suit for the baby to wear if it was a boy, and bangles if it was a girl. India has a fascinating culture, she says, and she plans to bring the child to India to expose him or her to "50% of their background". The prospect of raising a mixed-race child doesn't faze her. The daughter of a diplomat, she was born in Pakistan and says she has fond memories of her childhood Pakistani friends. "I'm curious to know how the baby's going to look being Danish-Indian. I like coloured kids. I find them cute. I find mixed blood gives a bit of a boost."
She plans to tell the child the truth about the way he or she was conceived. "You can't lie to your child all your life," she says. But she hasn't yet thought about the fallout if the child wants to know more about its genetic parents. "It's preferable that they're kept anonymous. What's the meaning of finding out?"
Aleksandrova herself knows very little about the donors. Her baby's father, she learned from the bank's online catalogue, is 6ft 4in, an architectural student from a family of doctors and "musical". She knows even less about the baby's biological mother, the egg donor. They have never met and donor anonymity prevails in India. "The doctor asked me what I wanted. I said I wanted a young, healthy woman with a child. Because I'm Caucasian, I wanted a fair-skinned person. The doctor said 'she is good-looking with some education'. I'd love to know more. But I trust him. I don't think he picks someone off the street," she says.
In Britain, there is an acute shortage of women donors. Had she stayed here, Alexsandrova would have faced a long wait for eggs, a bill of £7,000, and a cap on the number of embryos planted in her womb - a restriction aimed to prevent high-risk multiple pregnancies but, in her eyes, a curb on her chances to have a baby.
It is different in India; there, the market rules. Clinics' websites offer "many healthy young fertile Indian women" who are "superovulated exclusively for you" in dollar rates payable online by credit card. Moreover, Aleksandrova's Indian clinic put more than double the number of embryos allowed in the UK into her body. "I understand multiple-births are not a good thing," she says. "But for women like me whose bodies reject embryos, the higher the number, the greater my chance."
Alexsandrova is part of a growing number of global fertility tourists from rich countries such as Britain who fish for cut-price genetic material from India's pool of highly trained, English-speaking doctors.
It is a phenomenon wholly distinct from medical tourism, where patients needing a hip replacement or heart bypass receive identical treatment minus the waiting list and the large bills. Reproductive holidays in India are a real getaway from conditions back home. Fertility tourists are often people desperate to break free from not only financial, but also legal and ethical constraints, in a bid to create life. And Indian clinics woo patients with the language of free choice and a can-do attitude.
Age, for example, rarely poses a barrier in India. Earlier this year, twin girls conceived by IVF in India were born in the Midlands to a British Indian couple with a combined age of 131. Their mother, thought to be 59, is one of the oldest women in Britain to give birth.
Ethnicity is no problem either. Those making the trip to India are not just people of Indian descent who want a baby who resembles them. Increasingly, they are white couples that have no problem with the idea of having brown babies.
India was the second country in the world after the UK to produce a "test-tube baby" - the Indian girl was born just 67 days after Louise Brown in 1978 - but it has yet to create a single law regarding infertility treatment. Instead, Indian IVF doctors are self-regulating and only have to refer to a set of guidelines, not work within them.
Meanwhile, Britain has spent the past 30 years reforming infertility laws through public debates. These began with the Warnock Committee in the early 80s, which examined the moral, scientific and religious issues raised by IVF and led to the establishment of the world's first statutory body of its kind - the Human Fertilisation and Embryo Authority - to license and monitor clinics.
Three decades of scrutiny of IVF techniques in Britain has resulted in a recognition of the emotional maelstrom inherent in the creation of life. The result is that not only do British doctors consider the scientific possibilities of having a child, but also the impact of assisted reproduction on a child's emotional wellbeing, human rights and racial identity. Just because you can do something does not mean you should, is the maxim in Britain. The opposite appears to be the case in India.
There, the growing number of white westerners turning up for fertility treatment is reported in the press not as an ethical dilemma, but simply as another example of how the country is "booming": it is a source of national pride that India is getting foreigners pregnant where their own countries have failed. "Move over yoga, Ayurveda, there's a new Asian hip trend starting up ..." begins a story in the Indian Express on a British couple at a Mumbai clinic.
Similarly, while Diane Blood faced years of legal challenge and moral handwringing in her quest to use her dead husband's sperm for IVF, her Indian counterpart, "Puja", became India's first woman earlier this year to conceive with her dead husband's sperm. There was no fanfare, legal wrangling or public debate; her pregnancy was simply reported as a happy ending to a sad story.
One of India's most vocal proponents of patient choice is Dr Aniruddha Malpani, a favourite among British fertility tourists. To get to his clinic, on the edge of Mumbai's upmarket shoreline, his foreign patients must travel from the shiny new airport, past glass towerblocks in the shadow of which ragged children play in fetid pools beside pavements where they sleep, before arriving in a street lined with palm trees. A lift carries them several floors up into the compact, white-walled clinic where nurses scuttle between clean, sparse private bedrooms.
More than half the clinic's patients are from abroad. Hundreds like Alexsandrova, who have had no success in their own country, come to the man who says "yes". Sitting behind his desk in a small office, Malpani is a fast-talking defender of patients' rights, and sees the people he treats as consumers of a technology that needs only the lightest of regulation. As long as people can pay, let them decide, he says. He rails against the "sociologists" who question whether science can act without ethical restraint. "In whose interests are we doing this stuff? Should there be someone sitting in judgment? It's best for the mother to decide what's best."
Malpani turns out to be master of medical propaganda. He calls his patients "reproductive exiles" from medical establishments that are hostile to their desire to have children. The people who come are not desperate, he says, they have been disempowered - and his team is intervening to allow them to "build families".
Malpani taps on the keyboard in front of him while we talk. When challenged on a point, he types rapidly and spins round the screen on which flashes the relevant web page to back up his argument. The impression is of a man in a hurry to prove the world wrong, with all the arguments at his fingertips.
In Britain, people conceived since 2005 by a donor have the right to information about their genetic parent once they reach the age of 18. Children conceived using donor eggs, sperm or embryos in India have no such right; there, donors remain anonymous. That's as it should be, insists Malpani: receiving an embryo from a stranger is no different from getting pregnant after a one-night stand, he says. "If someone just slept with someone and decided to have the baby, no one would ask her to reveal his identity. Just because it's a clinic, why do these questions get asked?"
Malpani also sees no problem with his clinic giving white patients the eggs and embryos of Indian donors, saying, "They've thought about it", before enthusing about how "alike" donor-conceived children's mannerisms are to their birth parents.
British medical thinking, he says, is not designed with the patient in mind. In Britain doctors and patients are encouraged to transfer a maximum of two embryos into the uterus. Any more and the risks of premature birth, smaller babies and children with language and behavourial disorders increases substantially.Malpani transfers up to five embryos. "We have the flexibility to give a woman the best chance," he says. "If they don't get pregnant at all, they are the ones to suffer."
By his own admission, Malpani is a libertarian. He is also a respected fertility expert - his IVF clinic has been named among India's best - with a CV boasting a string of awards and scholarships for his clinical skills.
His greatest advocates, however, are those patients he has enabled to have a child. Sitting on the sofa in their living room more than 6,500km away from Mumbai in Market Rasen, Lincolnshire, are Brian and Wendy Duncan. Wendy, 42, pulls her three-year-old daughter, Freya, on to her lap: the little girl was conceived with Malpani's treatment.
"Freya is just like me. I delivered her and experienced every moment of her growing," says Duncan.
What is striking on first meeting mother and daughter, however, is their difference: Duncan is the palest of redheads while Freya has the dark skin, black hair and brown eyes of an Indian. She looks nothing like her father, either, who is also white. To conceive Freya, Duncan had five fertilised embryos from an Indian couple implanted into her womb.
Duncan was denied IVF treatment on the NHS because she already had a daughter, now 22, and was both overweight and a smoker. So the Duncans went private, borrowing £8,000 for one IVF cycle, which failed. For their second attempt, in India, they spent half that amount, including flights and hotels. "I wanted a child. The system in Britain didn't allow me to have one, so I had to look for an honest alternative," Duncan says.
While ethical decisions in India are left in the hands of individual doctors, in Britain each proposed embryo or gamete donation is considered by a clinic's mandatory ethics committee made up of lay people, clinicians, nurses and counsellors. There is no blanket ban on interracial donation, says Pip Morris of The National Gamete Donation Trust, "but the donor would be matched as closely as possible to the recipient".
"For example, if you had two black recipients and a white donor then that would be questioned and refused. If there's any doubt about the welfare of the child, then a donation would not go ahead."
Duncan says Freya's racial difference is irrelevant to her. "I wasn't bothered when she was born and I'm not concerned now. What matters is that she gets all the love and care she needs growing up." But what if it's relevant to Freya? "Of course I'll tell her if she asks about it. But if she doesn't, I won't stick my neck out to tell her."
Duncan argues Freya's looming questions about the fact her genetic parents are from a different continent, culture and race will be little different from those of her eldest daughter, from a previous relationship, who is mixed race. "When I told my older daughter about her origin there was no problem and it shouldn't be too difficult for Freya to understand the dynamics of it."
In the global market of commercial fertility, India remains one of the cheapest places to buy gametes. In America the going rate for an egg from an Ivy League student is around $60,000 (£30,000). An Indian egg never fetches more than 40,000 rupees (£500), and in the country's small towns a woman is paid as little as 5,500 rupees (£70).
It is almost impossible to get an accurate picture of exactly who India's donors are. The issue is shrouded in secrecy. Part of the reason appears to be the social stigma of being a donor in a conservative society. When asked about the backgrounds of their donors, IVF doctors give a standard response: they are from lower middle-class families, and are all married, with at least one child. One says they might work as a secretary or in a shop and generally have "a little education". But all the doctors claim donors refuse to be interviewed.
Perhaps one unspoken reason for the secrecy is the ugly reality that some donors in a country as poor as India trade their eggs simply to stay afloat financially.
In a dusty rural hamlet near the city of Anand, in the western state of Gujarat, Pushpa clutches her seven-year-old daughter's hand and stares at the cement floor of her house. The 25-year-old sold one of her eggs to pay off crippling debts after the family was reduced to eating just one meal a day. Her husband earns 2,800 rupees (£35) a month labouring on a construction site. "A moneylender would have stripped us of whatever little gold we had. I could not let my last bit of security go," she says.
The emphasis placed on informed consent, rights and counselling for egg donors in rich countries are absent in Anand. Moreover, the medical risks associated with farming eggs, such as pelvic infection or ovarian hyperstimulation syndrome - which in severe cases can be life-threatening - are often hidden from donors."The doctor told me there were no risks; that donating was just selling something that will be wasted away from my body anyway," Pushpa says.
Of even more concern, say critics of India's unregulated IVF industry, is the way that some doctors try to maximise profits by overdosing donors with hormones to stimulate them. "The amount of drugs pushed into them is way above the recommended dose," says Dr Puneet Bedi, a Delhi-based consultant obstetrician and gynaecologist specialising in foetal medicine. "If guidelines say to give 10 shots, they'll give 20 to increase the harvest rate and optimise their conception rates. Because IVF is a completely commercialised industry in India, it's all about delivering to whoever's paying."
The result is that the risk to a donor's health is amplified, says Bedi. While in Britain there is officially a 1% to 2% chance of egg donors getting hyperstimulation syndrome, Indian donors face "a many, many fold risk" in comparison. "We don't really know what happens to these women. Who pays for her life-threatening treatment? Nobody cares. Nobody's answerable."
Pushpa is matter-of-fact about her decision. "You wouldn't ask me why I did it if you'd ever lived on one meal a day," she says bitterly. "Selling the egg was quite easy. I was given some medicine; they took it out. I got the money."
So lucrative was the 5,600 rupees (£70) she received for donating, she did it twice more. "I wanted to send my children to a good school. They will have a better future. This was only possible because of me - a woman. After all, men can't produce eggs," she says.
She doesn't know who bought her eggs. "I don't feel exploited; here, in the villages, every aspect of life is exploitative - where you can work, what you can eat, when you have sex. This is the best option available to me," Pushpa says.
Not all Indian egg donors come as cheap as Pushpa. At the top of the country's social ladder are urban college students, who sell their eggs to bankroll their penchant for new clothes and gadgets. Sipping a cappuccino on the terrace of a cafe in a bustling Mumbai business district, one 20-year-old physics student - who agrees to speak anonymously - explains why she sold her eggs to one of the city's infertility clinics for 20,000 rupees (£250).
Some of her friends had sold their eggs and so she began searching clinics' websites. "If I can earn more money than getting a part-time job, then why not?" she says. "I needed to buy a new mobile and wanted to go abroad on vacation with my friends. I have always had what I wanted in life. But for my own enjoyment, I can't ask my parents for money all the time."
Although she is dressed in jeans, a T-shirt and designer shades, like any other affluent student in India's financial capital, she is acutely aware of the stigma surrounding donation in India. "My parents must never find out. They wouldn't understand why I did it," she says. "They'll think I'll never be able to be a mother myself. It's in the best interests of the family to keep it a secret."
Time is up. She waves down a taxi and hops inside. "I couldn't afford this ride earlier and now I can," she says as the car pulls away. "What's wrong with that?"

mirror - Meet the Quains* (ER, THAT'S QUADS WHO ARE ALSO TWINS..)

These two sets of twins are doubly special - they are also quads.
Ivf tots Andrew and Sienna were born to Karen Wesolowski, and Sophia and Alex to lesbian partner Martha Padgett. All four babies were conceived from Martha's eggs.
Just as unusually both gave birth on the same day. They opted for the double IVF as Karen, 42, had suffered three years of failures. Once Martha, 38, had her eggs fertilised with donor sperm, each woman got two embryos to boost their chances.
Martha, a nurse who already has a 10-year-old daughter, said: "We just wanted one baby. But when the doctor said we were both pregnant, we could hardly contain ourselves."
The couple, of Riverside, California, got a bigger shock when they learnt within a month how many tots were on the way.
Martha said: "We knew from research we'd done that there was a chance but we laughed it off. Once we heard four heartbeats we thought, 'Oh my God, we're going to have quads!' We couldn't believe it."
The final amazing coincidence came as both gave birth within 22 hours of each other. The non-identical tots, a year old next month, are all healthy.
Karen said: "We have four babies who are all brothers and sisters. Our family is complete." Keith Reed of the UK Twins and Multiple Births Association admitted: "This is very unusual."
Baby boom
The odds of having a multiple birth without IVF is just two per cent. But with IVF the risk rockets to 25 per cent.
Large family
The largest surviving multiple birth is the McCaughey septuplets born in Iowa, USA, in 1997 to Kenny and Bobbi.

Tuesday, 29 July 2008

evening telegraph - triplets bowling them over

At just eight years old the Hicks triplets are already taking on all-comers on the bowling green.
Katie, Matthew and Oliver Hicks have become a regular fixture at Irchester Bowls Club since taking up the sport five years ago and are now able to compete officially as full members.And although the game is one normally associated with older players, the youngsters are a popular sight for club members.The trio's grandmother Janet Mears said: "When they were in their prams we used to take them down to watch the bowling and they loved it right from the word go."They wanted to try it when they were toddlers. The bowlers down there gave them small bowls but they were a bit too big for their hands."We have just bought them a set of bowls designed for children of their age. Everybody down at the club loves talking to them, and I think it is nice that they are getting involved with the older generation in this way."The Evening Telegraph first reported on the triplets in 2003, when they were three years old and just as enthusiastic about the game as they are now.Mum Claire Hicks said: "The triplets have always gone down to the club with my dad. They are very keen to do it properly when they are old enough."They are really good kids, most of the time, and it's nice that they can do this together."Katie said: "I enjoy bowling. "I like my turquoise ball, and it is good fun with my brothers."The children are not the only young fans of bowls. Last week the Evening Telegraph reported that pupils from Brooke Weston CTC in Corby were invited to try the game by members of the Stewarts & Lloyds Bowling Club in Occupation Road. The taster has seen many of the pupils pledge to take up the game as a hobby.Tony Alcock MBE, chief executive of Bowls England, said: "It is absolutely great to hear that these children are enjoying bowling so much."Many young people are playing the sport these days and there are a lot of opportunities for young people."I have been at the All England Under 18s Ladies Final in Leamington Spa, and one day I hope to see the triplets at similar events."
The full article contains 394 words and appears in n/a newspaper.

irishtimes - Double trouble

Getting two for the price of one means twice the challenge, and the birth is only the beginning
THEY MAY not be average parents in any other way, but film star couple Angelina Jolie and Brad Pitt must have been very relieved to leave the hospital in Nice 10 days ago with two healthy babies. Getting two for the price of one inevitably increases the risks during pregnancy and delivery; twins are more likely to be premature and have a low birth weight.
But once the medical complications are behind you, the challenge of raising two children in tandem is just beginning. And only those who have gone through the experience of multiple births really know what it is like.
It’s hardly surprising then that Jolie and Pitt have reportedly been looking for advice from other parents in Hollywood circles who have had twins, such as Julia Roberts and Danny Moder, who have a son and a daughter, Phinnaeus and Hazel, now three.
At least celebrity couples are not short of helping hands. The latest additions to the Pitt-Jolie family, Knox Leon and Vivienne Marcheline, are likely to have at least one nanny each. With another four children in the household – birth daughter, Shiloh, who was born in Namibia in 2006, and three adopted children: Cambodian-born son Maddox, daughter Zahara from Ethiopia and Pax from Vietnam – there is plenty of work for an entire childcare team.
However, no matter how wealthy you are, early months with twins are tough. The hired help can only do so much. Jolie was reported to have breastfed Shiloh, but feeding twins is exhausting.
Charlotte O’Brien (41), the mother of twin girls Emilie and Lucy, managed it for six weeks and was then relieved to switch to bottles. “It’s too demanding with two of them, they don’t feed at the same time.”
But Corrinna Moore (37), whose twins boys, Cormac and Aran, were born six weeks early and spent 12 days in special care, says the hospital helped her by starting a routine where they were fed at the same time. “I don’t know if, left to my own devices, I would have achieved such a fine-tuned routine.”
When she left Queen Charlotte’s Hospital in London, where she was living at the time, she continued to do what she had been advised – when one woke to feed, she woke the other and put one to each breast at the same time.
“Otherwise you wouldn’t have a minute to yourself.”
Their tummies were so small, they were feeding every one-and-a-half hours so even nursing them simultaneously was a pretty constant business.
“One day I was determined to get out of the house,” Moore recalls. “But by the time I had them fed, then the bag packed and was out the door, they started to cry: they needed feeding again. I sat down and cried too.
“You can’t breastfeed twins in public. You need your couch and your feeding pillows.”
As for any parent of a new-born, it’s the feeding and the sleeping which are the biggest issues in the first few months – but with twins it’s undoubtedly at least double the trouble.
“I will never forget those first six months of no sleep at all,” says O’Brien. She and her husband, Ashley, look back and say “how did we do it?”.
“Emilie never slept through until she was a year old. At one stage she was waking every half hour. For the first eight weeks they were together in the same room. Then we put them in separate bedrooms and that was the first night Lucy slept through.”
Out of sheer exhaustion, the couple hired a night nurse three times a week for a while, which was a life-saver for them. The moment she came in the door, the nurse took charge of the babies and sent the O’Briens straight to bed. Those were the months of physical slog but now, with the girls aged two-and-a-half, there’s a whole new set of challenges.
“They are very strong willed, strong personalities,” O’Brien says of the two fair-haired girls as they confidently explore the home of the Moores who live near them in Dalkey, Co Dublin.
“But they are very different and have been since birth. Emilie is quite demanding; Lucy is quieter and will sit and do things on her own.
“They both want to be with me. It’s very hard when there’s two children, one grabbing at each leg, and you can’t explain why you can’t pick them up at the same time. The moment they started to walk, it became difficult.
“They have no sense of danger and I have only one pair of hands. If I go anywhere, they inevitably want to go off in opposite directions. I do use reins but they don’t like them, they like the freedom.
“I went to Imaginosity which is quite big, with open spaces and four floors. Within five minutes I had lost one of them. It is a bit uncomfortable if you lose one,” she says wryly.
Moore laughs and says with her twins now aged six-and-a-half, she had forgotten what that was like. She recalls losing Cormac in Kew Gardens one day but at least she had a friend with her who could mind Aran while she ran “like a headless chicken” looking for the missing boy, thoughts of abductors and ponds racing through her mind before she found him happily playing hide-and-seek with her.
Like O’Brien, Moore’s twins were her first children, but she has gone on to have two more, two-year-old Lorcan and baby Aoife who was born last month. “In terms of practicalities, having one child at a time is easier,” she says. “But once you get twins to about two or three, it is easier than having a second child 18 months behind.
“I am glad I had the twins first. With subsequent children, the twins are so focused on each other they don’t care who comes after them. The sibling rivalry is for each other.”
Although both mothers emphasise that their twin children are very different individuals, in each case their rate of development has been remarkably similar.
“At 16 months, they started walking the same day, within 20 minutes of each other,” says O’Brien. “Emilie stood up, she was the first born; the other one watched her and then stood up too. I couldn’t believe it!”
“Aran and Cormac both crawled, stood and walked on the same days,” says Moore.
Before the girls started to speak recognisable words, they developed their own language for communicating with each other.
“They were quite definitely conversing and I would not understand a word. I found it amazing. They still do it in the mornings and the evenings; you can hear them chatting away in their room.”
The next milestone is toilet training. “I have bought two potties and from next week I am going to see where it takes me,” says O’Brien.
Moore did it with one potty with Cormac and Aran, encouraging them to pee into it at the same time, but that’s boys for you.
From age three onwards, the emotional issues can become more apparent as they start to socialise. Moore says it was only when the boys started playschool, and found people getting confused about who was who, that they started to be aware of being twins.
She and her husband Richard have been careful not to lump them together, by not dressing them the same or by calling them “the twins”. Although not identical, it is hard to tell them apart. Luckily they support different football teams, so spot a Liverpool shirt and you can be sure it’s Cormac, while for Aran it’s all Man Utd.
Emilie and Lucy wear the same clothes out of choice. “Initially everybody gave me matching outfits but now they won’t wear different clothes,” explains O’Brien. “If one has a spillage and I have to change her, I have to change the other one too.”
While the girls will be starting playschool in September, the boys are already two years into their primary education in separate classes. All the received wisdom is to separate single-sex twins at school if possible, says Moore, especially boys as they are so competitive.
“They had started bickering and we felt they needed individual attention. It has been brilliant. Separating them has diluted the competition.”
For all their talk about the practical problems in raising twins, and their shared guilt about the lack of one-on-one attention they can give, both mothers stress the joy as well.
“It is special, no doubt about it,” says O’Brien. “For me it’s an instant family; they’re company for each other which I am pretty sure will continue.”
Moore agrees: “You get double the pain but more than double the love back.”

irishtimes - Twin support: from first-hand experience

PARENTS OF twins are adamant that people who have had only single babies "just don't get" what it's like to have two at the same time. So hearing about first-hand experience of twins is invaluable.
The Irish Multiple Birth Association (IMBA), which is run by volunteers, holds information meetings and is in the process of setting up local twin clubs. There's already one in Naas, Co Kildare, and in Galway, with others planned for north and south Dublin from the autumn.
"This time last year I would love to have gone along to such a group and met other expectant parents," says Siobhan Cullen, the mother of 10-month-old twins Albha and Caoimhe, as well as Donnacha who is two and a half.
"I called the IMBA when I was pregnant as it was the only place I could find information in an Irish context. Everybody's experience is different so it's helpful to talk to other mothers who have been through it, rather than get just one perspective."
Getting twins into a routine is key, she says. But that's easier said than done with two very different babies. It took her and her husband, Sylvester, four or five months before they got them into a routine.
Now she is a committee member of the IMBA, which is based in Carmichael House, Dublin 7. Most of the callers to its helpline are people expecting twins, who have queries about practical issues such as breastfeeding, co-sleeping, the best buggy, what financial support is available when you're having to buy two of many things.
Thanks to the tireless campaigning of Mairead Hilliard in the 1990s, the child allowance for each twin is 150 per cent of the standard rate.
As a mother of twin girls, who are now 25, "I found out triplets had been getting double payments since 1965," she explains and she thought it unfair there was nothing extra for twins. She wrote to newspapers, encouraged people to lobby their TDs, and badgered a succession of government ministers, until increased payments were announced in the budget speech of December 1997.
Hilliard also set up the first support group, Parents of Twins Ireland, and still runs a helpline today from her home in Lucan, Co Dublin.
Social welfare grants of €635 are also paid at the birth of twins, at age four and again at age 12.
The number of twin births in the Republic is rising, as women increasingly delay motherhood, and fertility treatment becomes more widespread.
Some 937 sets of twins were born live in the Republic in 2005, along with 13 sets of triplets and one set of quadruplets, according to the Central Statistics Office. This is equivalent to a rate of 15.5 sets of twins born live per 1,000 pregnancies, compared to 10.5 in 1985.
"I was in Blanchardstown Shopping Centre the other day and I walked past seven sets of twins in about 15 minutes," says Sarah Harris, public relations officer for IMBA and the mother of twins, Elle and Annaleigh, who turned one last Saturday, as well as three-year-old Jodi.
Living in Swords, she is helping to set up the north Dublin twin group which is due to start in the autumn but does not have a venue yet. The south Dublin group will have its first meeting in Marley Grange Parish Centre on October 1st.
The association will be guided by what members want, but as well as offering social contact, Harris says they are hoping to invite professionals to speak on multiple birth topics such as nutrition, education, psychological development, etc.
"Our website is being revamped," she adds, "our services expanded and our events and clubs will be a real benefit to parents and their children in the years ahead."

Friday, 25 July 2008

telegraph - Black and white twins a million to one chance

Parents Tracey-Ann and Andrew knew when they were having non-identical twins, they wanted to treat them as individuals.
But when Orlando came out black with lots of dark hair, and Natalia arrived a minute later with blonde hair and blue eyes, they knew they would not have to worry.
Delighted mother Tracey-Ann said: "Right from the start we said we wouldn't treat them as twins. We knew they weren't identical but we want to make sure we call them by their names rather than 'the twins' to keep their individuality.
"Now because they look so different to each other, it will be easier for them to be individuals."
Non-identical twins happen when two eggs are fertilised by two separate sperm.
Although they will share genes from the same parents, the way those genes are expressed will vary.
Orlando and Natalia are now three months old, and Tracey-Ann, 34, says the difference between the two has become even more evident as time has passed.
She said: "I think I was so caught up with the mechanics of having them, that I didn't really think about the difference at first.
"Now Orlando is even darker and Natalia looks nothing like me.
"Thank goodness for Orlando's skin colouring though otherwise I would have gone through all the effort of having them only for them both to look completely unlike me!"
Tracey-Ann is convinced the twins' different colour is due to past generations of mixed race in her family, while 28-year-old Andrew is also half-Italian, and is keen to make sure they grow up to appreciate their multi-racial heritage.
An IT consultant from Bristol, Andrew said: "They're not just one of each, black and white. They're half-Jamaican, one quarter-English and one-quarter Italian."
The chances of it happening are a million to one, although there have been a few cases in the last few years.
A German mixed race couple have just had their own black and white twins earlier this month.

Monday, 21 July 2008

this is wiltshire - All good things come in threes

A COUPLE who were told their premature triplets stood little chance of survival are about to welcome home the first of their miracle babies.
Amina and Maher Amawi, of Cumberland Road, Old Walcot, Swindon, went through six rounds of IVF fertility treatment in seven years before Amina finally fell pregnant last October.
But she unexpectedly went into labour while visiting her sister in Luton in March and the triplets were born at 24 weeks, weighing between 1lbs 4ozs and 1lb 8ozs.
Doctors warned the couple the babies were unlikely to live for more than a few hours and, even if they did, they would all be severely disabled.
Now, against all the odds, the first of the children - Layla, who now weighs 5lb 12ozs - is about to be discharged from Great Western Hospital.
And her siblings, brother Zayn and sister Tara, are likely to follow within weeks.
Amina, 31, said: "We know we have got our work cut out, but we are so excited for our babies to come home and for us to finally be a family.
"Nothing much has seemed real for the past few months. We've been on an emotional rollercoaster I can't even begin to describe.
"But the scariest parts are hopefully over now, and we have our children. We are determined to be the best parents we can be."
Maher, 36, a BT engineer, added: "The biggest shock was the size of them when they were born. Tara was the smallest - her head was the size of an egg and her whole body fitted into the palm of my hand.
"The first 10 days were the most critical and we had to take things hour by hour, then day by day, then week by week.
"We were elated, but it was terrifying at the same time."
A low point came when Zayn suffered a severe bleed on both sides of his brain at three days old. Medics said he was badly brain damaged, that he would never be able to walk and would probably be blind.
They recommended switching off his life support machine, but Amina and Maher refused.
"Call it a mother's instinct, but I believe he will be fine. Yes, he will have issues, and he will never be 100 per cent.
"But I am staying positive. An eye doctor has already told us he has some sight, and he can grip our fingers. We have even seen him holding up his own head."
In their four months of life, all three babies have undergone heart operations to close a valve. Zayn has also had a device fitted in his skull to drain off fluid.
Layla and Tara will both need oxygen for a while after coming home, and are expected to develop more slowly than full-term babies. Otherwise, no other health problems have yet been detected.
"Only time will tell if they have any other problems, but they have already overcome so much to be here," said Amina.
"They are real fighters. We can't wait for them to come home."

marie claire - Brad 'very emotional' dad

The doctor who delivered Angelina Jolie's new baby twins has revealed that Brad Pitt was 'very emotional' at their birth. Michael Sussman told press outside the Fondation Lenval Hospital in Nice – where Jolie underwent a caesarean section – that both parents were 'calm' but 'very emotional'. He said that during the labour the couple 'were talking, they were together', adding: 'It was an epidural, so [Angelina] was awake and speaking and laughing. They were happy.' He said that Brad was the perfect bedside partner – 'he was my assistant', he joked – and revealed the actor even cut the umbilical cords. Sussman added: 'He was ... perfectly calm, totally determined, very pleased to be at the birth of his children, very moved and very emotional.' Asked whether the birth had been a textbook delivery, Sussmann replied, 'absolutely no problems', although he did admit to some pre-surgery jitters. 'It wasn't pressure on a medical level because I have been practicing for a number of years, but it's true there was pressure due to the couple's fame. [But], things happened as I wanted them to happen – simply and efficiently.' Sussman went on to praise the 'exemplary mother and father', saying they were 'people of great simplicity, of great kindness. She is a patient who was totally obedient, very calm, very kind.' When asked how long Angelina will remain in the hospital, he replied: 'She will stay for a few days. You know, in Europe it isn't like in the United States, where the patients go home after three days. They will stay a bit longer until everything is okay.' He added: 'The babies are fine. The babies are with the mother and father and they are fine.'

National Research Strategy demanded to tackle premature baby deaths

The largest cause of infant mortality in the UK requires urgent government action, a leading scientist will tell MPs, Weds 16th July 2008. In a speech due to be given at the House of Commons, Professor Michael Taggart, Chair of Reproductive Sciences at Newcastle University will call on the government to develop the UK’s first, 10-year National Research Strategy to tackle premature birth.
Professor Taggart’s comments will be made at the launch of the charity Action Medical Research’s report, The Tiny Lives Charter, which argues that long term government support is needed to improve understanding of the causes of premature birth and find ways to reduce it. The report pulls together the views of leading medical experts, researchers, and professional and parent organisations. The call is also backed by a cross-party group of nearly 50 MPs.
Each year in the UK an estimated 50,000 babies are born prematurely — before 37 weeks of pregnancy (1,2,a). Each week more than 25 babies die as a result of complications arising from premature birth, the largest cause of infant mortality in the UK (3-5,b-c).
There are current government policies that focus on reducing infant mortality rates by tackling health inequalities and addressing known risk factors, as well as initiatives to continue to improve services. However, none focuses exclusively on the role of medical research in tackling premature birth.
Dr Yolande Harley, Deputy Director of Research at Action Medical Research explains: “Despite improved care for newborn babies there has been no corresponding progress in reducing the rates of premature birth. Many babies still die and those who survive are at risk of lifelong health conditions.”
“The causes and potential risk factors are not well understood and diagnosis of preterm labour is difficult. Evidence suggests that women with no obvious risk factors, particularly first-time mothers, deliver as many as half of all premature babies.”
The report, part of the charity’s ongoing STAND UP for Tiny Lives Campaign, argues that a National Research Strategy focused on improving understanding of the causes of premature birth could help lead to the development of targeted measures to reduce infant mortality and improve child health.
Prof Michael Taggart said: “While high-quality research groups are active across the country much of their efforts are happening in relative isolation, impeding progress. We need to build on existing research and foster greater collaboration within the scientific and clinical community backed by government, the pharmaceutical industry and the charity sector.
Fiona Currie, whose daughter Lauren died as a result of infection following premature birth, said: “Premature birth can happen to any family. Until doctors have all the information they need to be able to deal with this problem families will continue to be torn apart. We need to know why premature birth happens.” - ends -
Notes to editor Both Professor Michael Taggart, Chair of Reproductive Sciences at Newcastle University and Fiona Currie are available for interview
2) For further information please contact the Action Medical Research press team on 01403 327 478 or via email patrick@action.org.uk
3) Copies of the report; “The Tiny Lives Charter - a cross-party call to tackle premature birth” are available at http://www.standupfortinylives.org/download/ - using the password standuptlc
4) The STAND UP for Tiny Lives Campaign is calling on the Department of Health (DH) and Department of Innovation, Universities and Skills (DIUS) to commission an independent Premature Birth Inquiry to lead to the development of the UK’s first 10 year National Research Strategy for tackling premature birth.
5) http://www.standupfortinylives.orgwww.standupfortinylives.org/map/ shows the names of the MPs already backing the campaign.
6) Organisations backing the STAND UP for Tiny Lives Campaign:
The British Association of Perinatal Medicine — www.bapm.org European Parturition Group - http://www.bristol.ac.uk/clinicalsciencesouth/eptlg/ * NCT (formerly the National Childbirth Trust) — www.nct.org.uk/campaigns Neonatal Nurse Association — www.nna.org.uk Neonatal Society — www.neonatalsociety.org.uk TAMBA — www.tamba.org.uk Scottish Neonatal Nurses Group — www.snng.org.uk
7) Fast facts There are around 700,000 live births in the UK each year (1) An estimated 50,000 babies are born prematurely each year in the UK (1,2,a) Each year, almost 1500 babies die in the UK as a result of complications arising from premature birth (3-5, b-c) Each week, more than 25 babies die in the UK as a result of complications arising from premature birth (3-5, b-c) About 40% of the babies dying each year in the UK, die as a result of complications arising from premature birth (3-5, b-c) An estimated 70,000 babies in the UK each year require some sort of special care when they are born (1,6) The combined government spend on research into premature birth was £5 million for 2005/6 (7). This figure covers both the Department of Health and Medical Research Council. The spend for 2006/07 was £6.6 million from the Medical Research Council (8). References 1. Office for National Statistics. Health Statistics Quarterly 35 (Autumn 2007), Table 2.1 2. The Information Centre, Community Health Statistics. NHS Maternity Statistics, England: 2003-04, 2004-05, 2005-06 3. ONS: Health Statistics Quarterly 28 (Winter 2005), 32 (Winter 2006), 36 (Winter 2007) 4. General Register Office for Scotland, Vital Events Reference Tables 2006 5. Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2006 6. Department of Health. Report of the Neonatal Intensive Care Services Review Group. April 2003. 7. Dawn Primarolo MP to Julie Kirkbride MP. Hansard. 8 October 2007. 8. Letter from Ann Keen MP to Simon Moore, Chief Executive, Action Medical Research — copy available. Received June 2008.
Footnotes a. Estimate assumes incidence of premature birth is the same for the UK overall as it is for England b. For England and Wales, deaths listed as due to “immaturity related conditions” c. For Scotland and Northern Ireland, deaths listed as due to “disorders related to length of gestation and fetal growth”
Notes to Editors
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MEN - Twins weigh in at exactly 4lb 14.5oz

YOUNG mum Chloe Minchion was expecting her twins to be similar - but she didn't think they would weigh exactly the same.When the 17-year-old gave birth to Jacobe and Joshuah after a short labour, hospital staff saw nothing out of the ordinary.But all that changed when both babies tipped the scales at exactly the same weight of 4lb 14.5oz.Chloe explained: "The midwife couldn't believe it and said she didn't think it was right. "She called for someone else and they weighed them again on the electric scales - and it was right."She said news of the weigh-in spread rapidly around St Mary's in Manchester. "When I got back to the ward, everyone knew and they were all asking me about it," she said.Although the twins are not identical, Chloe says they have much in common."It's amazing," she said, "and it's not just the weight. When one sneezes, the other one does and when one crosses his legs, the other one does. It's amazing."They have mittens to stop them from scratching their faces and when one twin loses them, so does the other."They even went for a hearing test and both had the same ear blocked."The pair were born at 12.38am and 12.58am after a labour of about two-and-a-half hours. Now Chloe, from Longsight, thinks she could make the most of the similarities."They even feed at the same time," she said. "That should be good for me, because they wake up together and I can feed them both and go back to sleep."Chloe said she's only heard of one other pair of twins born with identical weights."Somebody told us the Kray twins were born weighing the same," she added. "But I hope they don't grow up like them. I'm sure they'll be good lads"A spokesman for the Multiple Births Foundation said it was `rare' to find twins with exactly the same birthweight.She said: "We see quite a few within a few ounces of each other but to get them exactly the same is rare, but it does happen ocasionally."

Wednesday, 9 July 2008

New Baby Jogger City Elite Double in stock


The new Baby Jogger City Elite, is the latest fashion-forward addition to Baby Jogger’s City Series family, has premium standard features that make it the best ride on the block. This all-terrain deluxe swivel wheel buggy can be customized from birth and beyond, allowing you to pamper your babes with comfort and style from day one. Now in stock at http://www.twins-store.co.uk/
The New Baby Jogger Elite double buggy from Baby Jogger is extremely easy to fold which saves time getting in and out of the car. Besides the revolutionary patented, one-step folding technology, the luxurious features on the Baby Jogger City Elite double buggy include a one-touch switch for swivel or locked front wheels, extremely comfortable 'pillows' in the seat-back, a multi-position handle and near flat recline vented seats with retractable weather covers, and 12” wide-tread comfort ride pneumatic tires. A six pocket parent console, adjustable handlebar and a large bubble canopy with clear view windows and side ventilation panels also come standard. With these first-class features and our unique accessory options, the City Elite Double offers the most comfortable ride for your precious cargo with unsurpassed quality and safety standards.

Plush padded seat with one-step recline to a near flat position
Vented seat recline with weather cover
12" comfort ride quick release wheels
Seat back storage compartment
Raised kicker for small children and easy access to under seat basket
Under seat storage basket can be accessed from all sides
Rear parking brake
Large multi-position "no pinch" sun canopies with clear view windows and side ventilation panels
Accessory mounting bracket
Suitable from birth

Telegraph - Two cycles of fertility treatment significantly increase chances of pregnancy

Receiving two cycles of fertility treatment can substantially increase a woman's chances of becoming pregnant, a new study shows.
The research will add to increasing pressure for women to receive more cycles of IVF on the NHS.
Most women in Britain are offered only one cycle by their local Primary Care Trust, despite a call from Patricia Hewitt, when she was Health Secretary, for all women to be offered three.
The new study showed that almost all women who would have become pregnant through a type of IVF, used in an estimated 40 per cent of cycles in Britain, did so on the first or second attempt.
A study of more than 6,700 patients shows that almost 80 per cent became pregnant on the first attempt with another 16 per cent on the second attempt.
Only 3.4 per cent of women became pregnant with their third cycle of treatment and less than one per cent on the fourth or fifth cycle.
There were no successful pregnancies beyond the fifth attempt, accordong the findings presented on Tuesday at the annual meeting of the European Society of Human Reproduction and Embryology (Eshre) in Barcelona.
The technique studied was intra-cytoplasmic sperm injection (ICSI), a treatment for male infertility which has been used since the early nineties.
The technique involves injecting an egg in a laboratory with an individual sperm.
It is used in an estimated 40 per cent of the 41,000 IVF cycles performed in Britain every year.
Simon Hong, from the Centre for Reproductive Medicine and Infertility at Cornell University in America said: "From our findings it appears that younger women undergoing two ART (assisted reproductive technique) attempts benefit from the highest chances of pregnancy."
Another study also presented at Eshre shows that using frozen instead of fresh embryos produces healthier babies.
Infants born from embryos which were frozen and then thawed before being implanted into a woman had a higher birth weight and were less likely to suffer abnormalities.
Fewer of the children were also twins or triplets.
Multiple births are known to increase the risk of complications as well as the danger to the mother.

Times - Frozen embryos 'make healthier babies than fresh ones'

IVF babies born from embryos that are frozen and thawed are less likely to be underweight or premature than those conceived during fresh treatment cycles, research has shown.
The findings show that the use of frozen embryos could soon be accepted as completely safe, doctors said.
Another team of researchers told the European Society of Human Reproduction and Embryology conference in Barcelona that IVF success rates could be improved by as much as 15 per cent with a “viability index” for selecting embryos with the best chance of a healthy pregnancy.
The Danish study into frozen embryos found that the average birth weight of those babies was 200g more than in fresh-embryo IVF.
The findings, from a team led by Anja Pinborg, of the Copenhagen University Hospital, are important because women are increasingly encouraged to use one fresh embryo — to avoid multiple births — and to freeze any others produced in the process for later use.
Dr Pinborg said it was highly unlikely that freezing improved the health of embryos. The figures could be explained because patients who froze embryos were generally young women with a good prognosis. Poor quality embryos were also more likely to die during the thawing process.
“These findings are reassuring,” she told the European Society of Human Reproduction and Embryology conference in Barcelona. “If our results continue to be positive, frozen embryo replacement can be accepted as a completely safe procedure, which can be used even more frequently.”
Scientists from Yale University told the conference that overall IVF success rates could be improved by as much as 15 per cent by a new “fitness test” that can predict which IVF embryos will implant into the womb up to 70 per cent of the time.
The non-invasive procedure examines chemical fingerprints in the culture media in which they grow in the laboratory. Scientists said the technology, known as metabolomics, should be ready for widespread use within two to three years, and predicted that the viability index could become a routine part of fertility treatment.
Denny Sakkas, who is leading the research, said: “The other side of IVF is that we probably fail to get patients pregnant about two thirds of the time we do an embryo transfer. One of the reasons is we’re not that good at picking the best embryo we have available.
“In the clinic, we would probably be looking at a 10 to 15 per cent improvement in pregnancy rates.
“It’s not going to make a bad embryo good, but it should help us to tell them apart. This definitely could make the difference between people getting pregnant or not.”
The average success rate for IVF in Britain is 21.6 per cent across women of all ages, and 29.6 per cent for women under 35.
There is no evidence that acupuncture during IVF treatment does anything to improve women’s chances of having a baby, the most extensive review yet has concluded. Sesh Sunkara, who led the research at Guy’s and St Thomas’ Hospital in London, told the conference: “If women come to me and ask if they should have acupuncture, I have to say there is no evidence that it helps.” She said more trials were needed to settle the issue

Tuesday, 8 July 2008

Irishtimes - Quads well enough to leave Rotunda at three weeks old

THE FIRST quadruplets born in the Rotunda Hospital in Dublin since 2004 went home with their parents Turrty Nkiru Chime (34) and her partner Pius Nwedo (38) yesterday, just three weeks after their birth.
Baby girl Cindy and her brothers Leon, Seán and Divine were remarkable in being born so close to full term having arrived at 32 weeks into the pregnancy on June 17th last.
Quadruplets are very rare, accounting for fewer than one in every 50,000 births, with an average of just one set born here each year. They are becoming more uncommon as advances in IVF (in-vitro fertilisation) mean fewer embryos are implanted.
However, the birth of these babies was even more unusual as their conception was not the result of fertility treatment.
“Spontaneous occurrence of quads is extremely rare. There were more in the past with IVF treatments but because of advances there, they really are exceptional,” Dr Adrienne Foran, neonatal consultant at the Rotunda, said.
The babies were more remarkable still for having such high birth weights for a multiple birth, ranging from 1.66kg to 1.86kg, and being born free from any additional health problems often associated with multiple births, Dr Foran said.
“With any multiple birth, even the birth of twins, there is a higher risk of complications, particularly with pre-term births. Reaching 32 weeks is in itself a huge achievement, but there are all the other risks such as twin-to- twin-transfusion, growth restrictions, poor placental sufficiencies . . . but none of these occurred here.”
Ms Nkiru Chime, who arrived in Ireland from Nigeria seven years ago just before the birth of her first child, was admitted to the Rotunda at just under 24 weeks and was kept in until the delivery by Caesarean section.
“One of the main reasons we kept her in hospital was that she already had three children at home and tiredness can impair growth of the babies,” Dr Foran said
Ms Nkiru Chime, who is already the mother of Junior (6), Tracey (4) and Princess (2), said she was shocked when she learned she was carrying quadruplets. “I came in for my check-up a few months into the pregnancy and they told me. I was very surprised, I thought they were joking, but it was frightening also.” The weeks since the birth had been tiring, she said, but she was delighted by how healthy her babies were.
“I have not had any sleep because I am breastfeeding and using bottles and they are eating a lot! They can never wait four hours, they just start crying for food, but I know this means they are very healthy. I will ask God to give me strength, but it is very stressful

Mirror - Status Quo rock star Rick Parfitt on being a dad to twins at 59

Veteran rocker Rick Parfitt proudly shows off his baby twins - and says: "They've given me a new lease of life."
The Status Quo guitarist has become a dad again at the age of 59 after he and third wife Lyndsay had IVF treatment.
And he said: "I never thought this would happen to me at nearly 60 - that I would meet, fall in love, marry the girl of my dreams and then have two more beautiful children.
"I knew happiness was out there. I just couldn't seem to find it. It's almost as if I've started life again. Of all the things money can buy, nothing can buy you anything as valuable as these kids."
The Mirror revealed in December how Rick and Lyndsay, 47, were expecting twins Tommy Oswald and Lily Rose. The guitarist has two sons - Richard, 33, and Harry, 19 - from previous marriages. Rick, who now lives in southern Spain, said Lily Rose is named after his mother. And he and Lyndsay finally settled on Tommy for their boy after debating over names Max and Zach.
Rick said: "We could have named him after the place he was born, as some people do, but Malaga Parfitt doesn't quite work. So I now have sons named Tom, Dick and Harry."
Rick told Hello! magazine his former wild lifestyle meant he had not been the best of fathers to his elder boys.
He said: "Twenty years ago, the rock and roll lifestyle came first. I didn't think of it any other way. I was on the road with the band and that was my life really.
"I had these lovely kids, Richard and Harry, and I didn't see much of them. I was too preoccupied enjoying myself.
"Now I've had my heart bypass and suspected throat cancer but I've survived. lot of my colleagues didn't.
"I'm more together now than I've ever been. t's unbelievably fantastic to be a dad again."
The full feature appears in this week's Hello! magazine, on sale tomorrow

Monday, 7 July 2008

Times - Risks of IVF twins exaggerated says US doctor Norbert Gleicher

Infertile couples who want more than one child should be encouraged to try for IVF twins in spite of the medical consensus that multiple pregnancies should be avoided, a senior American doctor said today.
The health risks of conceiving twins by IVF have been exaggerated by the medical profession, and a British initiative to cut the number of such pregnancies is “categorically wrong”, according to Norbert Gleicher, of the Centre for Human Reproduction in New York.
He told the European Society of Human Reproduction and Embryology conference in Barcelona that for many women who need IVF to conceive, the birth of twins is a “favourable and ethical” result.
Such pregnancies provide complete families at a stroke, and may often be safer than having two singleton IVF pregnancies, he said. Moves to persuade more women to use one embryo at a time during fertility treatment, as recommended by a UK national strategy launched last week, are thus misguided.
Professor Gleicher's comments were fiercely disputed by other senior doctors, who said that his opinions were based on a flawed analysis of the risks of multiple pregnancies to both babies and mothers.
Professor Peter Braude, of King's College, London, said that IVF twin pregnancies are well-established to be more hazardous than singleton conceptions, with dangers that include prematurity, stillbirth, low birth weight, cerebral palsy, pre-eclampsia, haemorrhage and maternal death.
“Couples should be extra cautious about interpreting this advice because it flies in the face of all other published data about the risks of multiple births,” he said.
The conference executive, which is encouraging IVF clinics across Europe to move to single embryo transfer to guard against multiple births, said in a statement: “There are significant risks to multiple pregnancies, and we should not be generating them deliberately. IVF babies also deserve the best start in life.”
A Human Fertilisation and Embryology Authority (HFEA) expert panel, chaired by Professor Braude, found in 2006 that twins have five times the usual risk of death in the first year of life and six times the risk of cerebral palsy. More than half are born prematurely, and 40 to 60 per cent require intensive care. Each twin costs the NHS 16 times as much as a singleton birth in the first year of life, and it is estimated that 126 deaths would have been avoided had all IVF twins born in Britain in 2003 been singleton births.
Multiple pregnancies are also dangerous for mothers. A quarter are complicated by problems such as high blood pressure, and the death rate is doubled for women expecting twins.
These dangers have led the HFEA and the British Fertility Society to launch a national strategy to reduce Britain's IVF twin rate from 24 per cent to 10 per cent by 2012. This is likely to require single embryo transfer in about 50 per cent of IVF cycles, compared to about 10 per cent at present.
Professor Gleicher, however, claimed that some of these risks had been over-estimated, because they have been calculated by comparing twin births with just one singleton pregnancy, not two. “When you ask infertile patients having treatment, a very large majority want more than one child,” he said. “The question is how you get two children, not one. When you add the risks of two singleton pregnancies together, many risks of twins disappear.
“For infertile patients, desirous of more than one child, twin deliveries represent a favourable, cost-effective and ethical treatment outcome, which in contrast to medical consensus, should be encouraged.
“Because the alleged excessive risks and costs of twin deliveries have been the primary motivation behind the recently increasingly popular concept of single embryo transfer, the clinical, ethical and economic validity of single embryo transfer should be seriously questioned.”
He added that much of the medical literature is based on comparisons between naturally conceived singletons and twins. This may be misleading because IVF twins have a lower risk than spontaneous twins of dying at or soon after birth.
In a paper published in the journal Fertility and Sterility, Professor Gleicher has suggested that when these factors are taken into account, IVF twin pregnancies are less risky than two singleton conceptions for complications including stillbirth, neonatal death and major birth defects.
Professor Braude and the conference doctors pointed out that even Professor Gleicher's adjusted figures show substantially raised risks of maternal death, low birth weight and pre-eclampsia, a life-threatening blood pressure disorder.
They added that for many risks, it is statistically misleading to compare twin pregnancies with two singleton pregnancies. Professor Mark Hamilton, the chairman of the British Fertility Society, said: “It is misleading, as he has done, to combine the risks of two single live births which are two independent events, each with a lower risk than that of a twin pregnancy.
“With singleton pregnancies, the chance of having a stillborn baby, or one that dies soon after, is about five per 1,000. In a twin pregnancy it's four to five times that. If your first singleton pregnancy was uncomplicated, your chance of a problem the second time round is even lower, probably less than one in a thousand. Multiple pregnancies unquestionably expose mothers and babies to increased hazards.”
Professor Gleicher's study has also ignored the long-term health risks of the low birth weights suffered by twins, and the psychological impact of multiple births on parents.
A separate study presented at the conference, from Helsinki University Central Hospital in Finland, has found that the mothers and fathers of twins suffer significantly more mental health problems, such as depression, anxiety and sleep disorders, than the parents of singletons.

Mail.co.uk - IVF experts should encourage twin births not cap them, says controversial doctor

Women could be denied the chance of having a baby by new restrictions on the number of multiple births, a leading fertility expert has warned.Norbert Gleicher, one of America's most successful IVF doctors, said the capping of twin and triplet pregnancies could result in fewer women fulfilling their dream of motherhood.The strategy, devised by Britain's fertility watchdog to reduce the risks associated with multiple births is 'categorically wrong' and 'dramatically misguided', he said.Instead of avoiding twin pregnancies, fertility clinics should be actively encouraging them, he added.Speaking at a fertility conference, Dr Gleicher said one twin pregnancy was no more dangerous than going through two separate single pregnancies.Having twins is also no more costly - and the increased earning power of two bodies rather than one may even benefit the economy in the long-term, his research suggests.What is more, having twins gives couples an 'instant family', removing the need for a woman who has struggled to conceive a first time to get pregnant again.But Dr Gleicher's comments, which are based on his review of more than 15 years of fertility studies involving thousands of twin and single births, have been hotly disputed by fertility doctors in the UK and abroad.
Fertility rowIn a joint statement, experts, including Professor Peter Braude, of King's College, London, said twins face 'huge obstetric complications', some of which can lead to a lifetime off suffering.Loss of one or both babies during pregnancy is a source of 'profound disappointment' which has no monetary value, they said.Concerns about the added risks of twin births has led to the country's fertility watchdog to the cap the number of embryos implanted at a time to one wherever possible.Twins are at much greater risk of stillbirth and cerebral palsy than their single counterparts. They are also much more likely to be born prematurely, placing extra pressure on an already cash-strapped NHS.Mothers are at a greater risk of developing pre-eclampsia, a life-threatening complication of pregnancy, and are three times more likely to die during childbirth.
With twin births accounting for one in four IVF pregnancies, The Human Embryology and Fertility Authority says the policy of single embryo transfer, which is due to come into from January 2009, will benefit both mother and child.But Dr Gleicher, of the Centre for Human Reproduction in New York, said the thinking behind the policy was fundamentally flawed because it simply compared the dangers of having twins to those of carrying a single baby.Factoring in the risks associated with becoming pregnant a second time cancels out the dangers of a twin pregnancy, he said.Medical costs are also unlikely to be higher in a twin pregnancy and women will benefit because they will only need to go through one set of IVF treatment.He told the European Society of Human Reproduction and Embryology's annual conference in Barcelona that limiting transfer to one embryo at a time would cut pregnancy rates, which are already lower than those in the US.'Single-embryo transfer does reduce pregnancy chances and therefore if the UK does go through with this process you will see a further decrease in pregnancy rates,' he said.'I and most of my colleagues are driven by what our patients are telling us. We strongly believe that nothing is more important to an infertile patient than getting pregnant and it is our principle responsibility to help them get pregnant quickly and safely.'But Professor Braude, who helped shape the HFEA's policy, urged caution, questioning Dr Gleicher's calculations and saying his conclusion 'flew in the face of all published data about the risks of twin pregnancies'.In a joint statement with other fertility experts, Professor Braude added that Dr Gleicher had not fully account for all the medical and emotional problems associated with twin pregnancies.'The saddest outcomes that we see in practice are those twin pregnancies where women go into very premature labour or lose both babies at around 25 weeks or less,' they said.'The disappointment and grieving that accompanies this loss is profound and cannot be calculated in dollars or pounds.'Whatever the hypothesis, which may be interesting for doctors to mull over and discuss, there are significant risks to multiple pregnancies and we should not be generating them deliberately.'IVF babies also deserve the best start in life.'

Sun protection advice for your babies

Sun Protection for Babies
Babies are born with fine, delicate skin that gets thicker as they grow. This can make their skin more sensitive to sun damage and allergens, for example, in harsh soaps and detegents. An allergen is any substance that causes an allergic reaction, such as redness or a rash.
The British Skin Foundation advises taking the following steps to help protect your baby's skin:
Limit the amount of products you use on your baby's skin. You don't need to use a moisturiser unless your baby has very dry skin, in which case use an emollient cream during the day and at bedtime. Choose softer cotton clothes rather than wool, which can irritate.
Avoid products that strip the skin of its natural oils and cause dryness. These include soap, shower gels, detergents and anything that bubbles or lathers. Avoid products that contain alcohol or added fragrances.
Never let your baby's skin burn in the sun. There is a strong link between childhood sun damage and skin cancer in later life. Babies should not be in the sun at all, and toddlers should be covered up with loose-fitting clothing, a hat and sunscreen of factor 30 or more.
In wet nappies, bacteria break down the urine into ammonia, which irritates a baby's skin. Avoid nappy rash (sore, red skin) by changing the nappy as soon as it's wet, and cleanse with cotton wool and water. Use a simple nappy cream as a barrier.
FACT: Unprotected exposure to the sun in the first 15 years of life more than doubles the chances of getting skin cancer as an adult.FACT: Nearly 80% of lifetime sun exposure occurs before age 18.FACT: 90% of all skin cancers can be attributed to UV ray damage to skin cells.FACT: Skin cancer is the most common form of cancer in the USA today.FACT: UV rays cannot be felt and are present whether or not it is hot outside.FACT: It takes less than 11 minutes for the sun to irreparably damage your skin.FACT: The ear, nose, lip and eye areas are very susceptible to skin cancer.FACT: A sun tan is a sign that the skin is already damaged. A sun tan does not protect the skin from further sun damage.FACT: Sun tans and sun burns increase your risk of skin cancer.FACT: UV is transmitted every day, even in winter. It takes longer to burn during the winter months, but sun damage occurs even on cloudy days.FACT: Beware of UV rays reflected off of sand, water, snow, concrete or any light surface.FACT: Babies do not require direct exposure to the sun; they receive enough vitamin "D" to help aid the growth of bones and calcium from indirect sunlight.FACT: Babies are very sensitive to the sun's UV rays.*Information compiled from The Skin Cancer Foundation and The Cancer Council Australia: Fact Sheet: Sun Protection and Babies: updated March 2004, http://www.sunsmart.com.au/.SUN SAFETY TIPSIf you and your family enjoy the outdoors, the best protection from the sun's rays is to use all of the following: hats, sunglasses, sun block, sunshades, 50+ UPF rated clothing and 50+ UPF rated swimsuits like those brightly colored swimsuits offered by Banz.Babies should be completely shaded from the sun at all times during the first six months of life or until your pediatrician indicates it is safe for them to wear sun block. Using sunshades such as the Protect-a-Bub sunshade or the Protect-a-Bub Deluxe 3-in-1 allows baby to enjoy the great outdoors while being shielded from UV rays.Keep baby protected during peak UV times when the sun is at its highest and strongest: between 10am- 4pm.Start teaching your children sun safe habits from an early age. Always require them to wear hats, sunglasses and a 50+ UPF rated shirt when swimming. Apply sun block each morning. Sun blocks take up to 20 minutes to become active on the skin.The most important tip for parents is to LEAD BY EXAMPLE!Review all sun safe shade and apparel product information carefully. Beware of products that offer more than one shade factor - i.e., part of the product is 70% another part is 90% or the shade provides "up to" 90% protection. Some shades only provide protection in certain positions. Sun protection does not start until a shade factor of 94% is reached - which equates to UPF15. Any shades providing less than 94% may not block enough UV rays to protect your family.Sun block is an effective way to protect the skin from UV rays. Always use with care and as directed. Sun block needs to be re-applied at 2 hour intervals to continue protection. Use sun block along with other sun safety measures like hats, sun glasses, T-shirts, umbrellas, sunshades and natural occurring shade.There are two main types of sun block - those that are absorbed into the skin and those that sit on top of the skin. Absorbed sun block penetrates the skin, removing or lessoning the UV from the sun's rays, protecting the skin. Some blockers sit on top of the skin acting as reflectors while others absorb the UV as it hits the skin, stopping the rays from penetrating into the skin. The goal of sun block is to prevent UV rays from penetrating deep into the skin where cancer cells mutates and can later cause skin cancer.Blockers containing titanium or zinc are generally better for babies and children because fewer chemicals are absorbed by the body.

Sunday, 6 July 2008

BBC - Twins see double at birthday bash

Hundreds of twins have gathered in Berkshire to mark the 30th anniversary of the Twins and Multiple Births Association (TAMBA).
Reading Twins Club held its annual summer party at Beale Park on Sunday to coincide with the occassion.
Two birthday cakes were cut by the oldest and youngest pair of twins in attendance.
Janet Avdiu, mum of babies Tom and Dan, said: "It's hard work but I wouldn't change it."
Lisa Kelly of the Reading Twins Club, said the organisation helped battle negativity.
"It's really difficult when you first have twins," she said.
"Everyone is really negative about it - double trouble.
"That does make it hard but we support each other."
Reading Twins Club was formed 15 years ago to support parents of multiples.

Saturday, 5 July 2008

thisisnottingham - Colwick parents hit jackpot with triplets

Life changed beyond belief the day Sze Kane gave birth. After ten years trying for a baby - and on her tenth IVF attempt - she found out she was having triplets.She discovered the startling news during a six week scan."They saw three heartbeats - that was quite a shock," said the former buyer for the Co-op.Sze, 48, and husband Jim, 57, set about buying three of everything - cots, car seats, high chairs and so on.The non-identical triplets were born at Nottingham City Hospital by Caesarean section at 32 weeks.Jak was first, weighing 3lb 12oz, Megan next, at 4lb 1oz and Joshua last, at 3lb 4oz.The operating theatre was packed as each baby had to have its own midwife, paediatrician and neo-natal nurse, in addition to the surgeon, anaesthetist and all the other health professionals.The triplets spent two weeks in the neo-natal unit before being allowed home to Colwick - and that's when the enormity of having triplets really struck the couple.Help from the authorities is only available for quads, so the couple got through the endless feeding and changing routine with help from Sze's mum, Jean Lam.Sze (pronounced Sue) said: "They needed feeding every three hours and it took around two-and-a-half hours to feed and change them, giving us 30 minutes between feeds."You had to try and get them in as tight a routine as possible or the small gap you've had disappeared and you'd get no sleep."The triplets got through 150 nappies a week and 18 bottles of milk a day, requiring two sterilisers and two kettles to keep up with demand."It was exhausting but exhilarating," said Sze."We spent ten years trying for a family so we really did hit the jackpot getting the triplets and no matter how hard it gets we would not change it for anything."The sudden expansion of the family meant that the Kanes had to have an extension built and buy a bigger vehicle to accommodate three car seats.And the 4ft-wide pram made getting out and about a real challenge."The first time I ventured out to Broadmarsh I couldn't get in the lift. Even at hospital appointments at the QMC I couldn't get it in the lift," said Sze.Food shopping was another problem. Asda was the only supermarket at the time which had a trolley suitable for three babies. Morrison's only had room for two, so the third baby's car seat had to go inside the trolley, leaving no space for food.A holiday in Majorca when the triplets were 18-months-old presented another problem."My mum had to come too because there had to be one adult per child on the plane," said Sze.They family usually opt for self-catering accommodation because few hotels have a family room big enough for two adults and three children.Jim, who used to work for a funeral company, quit work to become a house husband so Sze could return to work but when she was made redundant she looked after the children while Jim found work in a shop.The triplets are now five and last September started at St John the Baptist Primary in Colwick.They are all in the same class and because it is a small school are likely to remain together until they move to secondary school.Sze said: "They are quite insular in a way because they have got each other."When Megan broke her arm and didn't go to school for a few days the boys were upset."They always have someone to play with - but they still get bored."All three have friends for tea quite often."I do feel conscious when they go somewhere else as people who have one child are not geared up to their noise level," said Sze.But while it is treble the work, it's also three times the pleasure.Each child has their own distinct personality.Jak is the bossy one, Megan is typically girly and Joshua is the most sociable.The family are involved with Nottingham Trent Twins and Multiple Births Club and have made many friends, through the mother and baby groups and outings.Sze said: "Given the time we spent trying, having one baby would have been beautiful but finding we were having three was worth all that heartache."It's a very special thing for us."

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