Tuesday 26 July 2011

Eating disorders and your fertility

It has taken a 'celebrity' (I've put it in brackets only because I'd never heard of her..) to raise awareness of the way eating disorders can affect your fertility - but it's certainly time women understood that excessive dieting can damage your chances of having a family in the future. When a woman's body weight drops too low, her periods will stop. Most women know this, but assume that their periods will return to normal once weight is regained. Unfortunately, this isn't always the case and some of those who suffer from anorexia will discover that they don't start ovulating even if they do get back to a normal weight - and medical help will be needed to give any chance of ever having a child.

It's not just anorexia that can affect fertility, but bulimia and yo-yo weight loss too. Bulimia has been linked with polycystic ovary syndrome, which often affects fertility, even in women whose weight isn't abnormally low and yo-yo dieting with rapid weight loss and gain can also play havoc with ovulation.

The obsessive nature of eating disorders means that women often consider any future health issues to be a very low priority, but perhaps education at an earlier stage about the long-term risks for fertility might be a good thing.

Tuesday 12 July 2011

Surrogacy law - does it need updating?

Leading fertility lawyer Natalie Gamble has just sent me a press release about a complicated surrogacy case which has just been through the courts here in the UK. Natalie feels it highlights some of the problems with the current legislation surrounding surrogacy - and it certainly does show how hugely complex the issues can be - see below...

The High Court has made an unprecedented order awarding parenthood to a deceased father of a baby boy born through surrogacy in India.

A couple, known only as Mr and Mrs A, entered into a surrogacy arrangement and their son was born in India on 12 April 2010. The biological parents were Mr A and either Mrs A or an unknown donor. However, under UK surrogacy law, the Indian surrogate and her husband were treated as the baby boy’s legal parents, and Mr and Mrs A applied for a parental order to reassign parenthood and gain a UK birth certificate naming them as mother and father. But Mr A tragically contracted liver cancer during the course of the proceedings and died, leaving the High Court to make a landmark decision to award parenthood to the mother and her deceased husband.

The case was complicated by the fact that only couples – and not single people – can apply for parental orders. When the UK’s surrogacy laws were debated in 2008, Parliament decided that only couples should be able to commission surrogacy arrangements. Parents who apply for parental orders following surrogacy must therefore either be married or living as partners in an enduring family relationship.

Leading fertility lawyer Natalie Gamble, who drafted an amendment to the law in 2008 (which was debated in Committee but rejected) which would have allowed applications from single parents, comments: “The case shows how dangerously outdated our surrogacy laws are. Although Mrs Justice Theis was able to find a way around the law in this case because the father had died after issuing the application, what would have happened if either of the parents had died earlier, perhaps during the pregnancy? This has always been an accident waiting to happen, and the restrictiveness of the current law is leaving children vulnerable and unprotected.

Natalie, whose firm has dealt with many of the leading international surrogacy cases heard by the High Court in recent years including the first to ratify a foreign arrangement, goes on to say: “The case demonstrates the continuing difficulties the courts are facing in dealing with surrogacy arrangements. The High Court is repeatedly having to stretch the legislation in order to secure the status of vulnerable children born through surrogacy, and the emotional and financial cost of this for the family involved is significant. We need a better system of law which caters for these kinds of eventualities, and gives clarity and certainty to ensure that children being born through surrogacy (and their parents and surrogates) are properly protected.”

The case is also the first published case to ratify an Indian surrogacy agreement in which more than expenses were paid to a surrogate mother, following a line of previous published cases ratifying commercial payments for surrogacy made to US and Ukrainian surrogate mothers.

Monday 4 July 2011

IVF risks

If you'd read some of the newspaper headlines about IVF this morning, you could be forgiven for getting into a bit of a panic. It sounded as if going through IVF put you at a hugely increased risk of having a baby with Down's syndrome, and that it was the drugs used during fertility treatment which caused the problem.

This research is undeniably interesting, but it's far from conclusive. The eggs of just 34 couples were examined, far too few to be truly representative, and the reason for the problems they found is not clear either. They saw that when older women took higher doses of fertility drugs during treatment, there were abnormalities in the eggs which were produced. These abnormalities appear to be different from the more common problems which occur in older women's eggs anyway.

There are a number of things that need to be understood about this. The eggs studied were far more likely to lead to an unsuccessful treatment cycle or a miscarriage than to a baby with serious problems. The researchers have suggested that ovarian stimulation could disturb the normal process of egg production, but it is also not clear whether the fertility drugs caused problems for the eggs or whether the treatment allowed eggs to be produced from the ovaries which might otherwise never have got as far as being released.

So, we would like to see more research in this field to discover whether pushing older women's ovaries to produce more eggs actually only results in larger numbers of poor quality eggs - but in the meantime you can find out more about the research at www.eshre.eu