End of one-child policy means mayhem in China's IVF sector

The Nanfang clinic in China's southern Guangdong province says it offers Chinese patients seeking in-vitro fertilization (IVF) the chance to choose the gender of their child, avoid stringent approval checks and snarling queues.

It has to advertise this with caution. China's strict regulation of its IVF market forbids gender selection, requires birth licences and proof of marriage, and prohibits some more advanced procedures - rules that have pushed patients to go overseas or seek treatment in unregulated clinics at home.

Demand for IVF in China is expected to rise after Beijing scrapped its controversial one-child policy in October, which will strain already-crowded state-run hospitals but create opportunities for overseas health centres, firms helping train local doctors - and underground clinics.

"Here we can do IVF with gender selection and you don't need lots of documentation," a doctor at the Guangdong clinic surnamed Hao told Reuters, adding there had been a 50 percent jump in consultations since the one-child policy announcement.

She said many of her patients were younger women opting for IVF so they could choose a boy, a traditional preference. The doctor did not give her full name and "Nanfang" is a common name for businesses in southern China.

Beijing's tight control makes it hard for private firms to operate IVF clinics in the country, but growing demand for doctors and specialists has created other gaps in the market.

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"Training to help up-skill clinicians and embryologists to treat the patients is definitely a big growth area," said Jason Spittle, global director of training at U.S. medical device maker Cook Medical, which has a reproductive health unit.

"China is set to be the biggest IVF market in the world, probably within the next couple of years."

Looking overseas

Chinese couples who have the financial means often go abroad to the United States, Australia, Thailand and Vietnam for IVF.

"The biggest driver is that there are so many hoops to jump through to get IVF treatment here," said Mr Lei, a China-based intermediary who helps patients go to Thailand, who like many Chinese was reluctant to give his full name to a reporter.

Rising Chinese demand for fertility treatments is therefore good news for overseas clinics such as Australia-based Monash IVF Group and Virtus Health or Superior A.R.T. in Thailand, where 30-40 percent of patients come from China.

"Our clinic has prepared Chinese-speaking staff to coordinate with rising number of Chinese patients," said Superior A.R.T. deputy manager Arnon Sinsawasdi, adding the end of the one-child policy should give business a boost.

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IVF Australia, part of Virtus Health, plays on Chinese demand for the latest procedures with a Chinese-language website advertising its "cutting-edge technology" to help parents "achieve their dream of having a child".

"Lots of patients go to these places just because they have unique demands. For example domestically they can't do things like surrogacy or gender selection," said Li Yuan, director of reproductive medicine centre at Beijing Chaoyang Hospital.

Non-commercial surrogacy is allowed in Australia, while the United States permits gender selection. Thailand, though, has been cracking down on both practices to close loopholes that have lured patients from overseas.

Overloaded clinics

Patients and doctors in China said state IVF centres were often over-stretched - little surprise given each clinic serves around 3.8 million people, compared with 700,000 people per clinic in the United States, health ministry data show.

"Clinics are so busy it's unbearable. Whichever hospital you go to it's always crammed with people," said a junior doctor at an IVF clinic in Shanghai, who asked not to be named.

This creates a market for unregulated providers, who advertise their offerings online and on social media platforms, while avoiding detection by overworked watchdogs despite a recent crackdown on the market.

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"In the past few years our checks in some areas haven't been strict enough, routine oversight has been lax, and strikes against illegal behaviour have fallen short," China's health ministry said in a statement in July.

"That's led to chaos in the assisted reproduction market."

Patient numbers are still climbing too. There were nearly half a million treatment "cycles" in 2013 at 356 approved clinics, compared with just under 200,000 cycles that year in the higher-value U.S. market.

Despite the growth, though, many still struggle to get access to IVF at all: poorer provinces have few clinics and many can't afford a pricetag that starts at 30,000 yuan ($4,697).

"You can't use state insurance, it's all paid out-of-pocket," said Ms Cui, 37, a financial worker in Dalian who underwent successful IVF treatment in 2013.

"I was lucky that it worked in one go, but many people try a number of times which mean it's even more expensive."

5,000 women give birth in Beijing by IVF

Infertile couples in Beijing using in vitro fertilisation (IVF) treatment to have a child is on the rise with about 5,000 babies born each year in the capital, the municipal health bureau announced on Sunday.

With the rise in the use of treatment and concerns about unlicensed clinics, the health authority is establishing a quality control center to supervise the assisted reproduction technique.

The move comes as the city celebrates the 25th birthday of the country's first tube baby - Zheng Mengzhu.

Zheng, 25, now works in the gynecology center of the Peking University Third Hospital, where she was born to her then 39-year-old woman in 1988.

According to the hospital, 370,000 couples visited the gynecology center last year with 80 percent of those who had IVF treatment delivering a baby.

Getting married later in life and the increased pressure of work and environmental conditions are causing more infertile couples. Experts have called for more legal support to tackle unlicensed clinics and surrogate births.

 

Vitrolife Is The First Company In China To Receive Regulatory Approval For An Entire IVF Culture Media Portfolio

Vitrolife (STO:VITR) is the first company to receive regulatory approval for an entire IVF culture media portfolio in China. With the approval from Chinese SFDA (State Food and Drug Administration), Vitrolife can now provide a unique level of compliance to the IVF community with products covering all steps of an IVF treatment.

"It has been a long and intense journey to secure that our customers can work with ease of mind, fulfilling regulatory requirements". We are very proud and happy to be the first company to offer approved quality leading products from retrieval to transfer", says Dr. Meishan Jin, Vitrolife's Regional Manager Asia

This approval confirms that Vitrolife brings safe, efficient and certified products in the hands of IVF professionals.

"China experiences very rapid growth in terms of IVF treatments and Vitrolife are one of the companies best positioned to take care of that growth. With this approval, our growth will be further leveraged for the future, says Dr. Magnus Nilsson, CEO Vitrolife"

During the approval process the company has cooperated closely with national authorities, to set the quality standard for IVF-products and secure that customers can work according to Chinese rules and regulations.

The SFDA approval adds to the list of stringent regulatory approvals of Vitrolife products for CE-mark, FDA, Canada Health, TGA accompanied by many local registrations.

Source:
Vitrolife

Japanese woman pregnant with wrong egg after IVF mix-up

A Japanese woman became pregnant with another person's baby following an egg mix-up during fertility treatment.

The mistake happened when the woman, who is in her twenties, underwent IVF treatment at a government-run hospital in Kagawa Prefecture.
But medical tests during the early stages of pregnancy revealed the implanted egg was unlikely to have come from the mother.

Further investigations led to the discovery that the fertilised eggs of another patient had accidentally been implanted.
The woman decided to abort at nine weeks upon discovery of the blunder and are now seeking £149,000 (in compensation from the prefectural government.
Yuzo Matsumoto, director of Kagawa Prefectural Central, said: "She was very happy after undergoing such a difficult procedure and becoming pregnant, but unfortunately a mistake had been made."
"The in vitro procedures are carried out in sequence one after the other. In this case the eggs from one procedure may have accidentally been left over and used in the following procedure."
Fertility treatment is increasingly common in Japan with thousands of women undergoing IVF treatment every year, during which a women's eggs are removed, fertilised outside the womb and then implanted in the uterus to lead to pregnancy.
However, medical groups traditionally do not encourage raising and bearing children who are not related to the mother. As a result, surrogate births and adoptions are comparatively rare in relation to other industrialised nations.

Researchers Worried about Limp Korean Sperm

The sperm of young Korean men is growing weak. Although there is no problem with their sperm count, over the past five years Korean men have produced significantly small numbers of healthy, actively mobile sperm cells. Experts blame the phenomenon on environmental hormones that affect the reproductive system.

Professor Han Sang-won of the Department of Urology at Yonsei University's College of Medicine studied the sperm of 102 students from a Seoul university between April and November last year, and discovered that the average motility rate of the sperm was in the upper 40 percent range.

The motility rate is the percentage of healthy sperm that can reach the female egg; a rate of 50 percent or more is considered healthy by World Health Organization standards.

The motility rate of sperm from 20-something Koreans has been declining for the past five years. From 1999 to 2001 it was an average of 66 to 83 percent. Then it dropped to upper 40 percent in 2002, and has been below normal since.

The sperm that Professor Han's team collected came from otherwise healthy Koreans in their early 20s. The researchers studied soldiers until 2004, athletes in 2005, and normal university students last year.
"The decrease in motility is serious in that it can become the major cause of sterility in men," Professor Han said. Detailed research results will be announced in July.

The researchers also discovered that the sperm count of the same group of university students showed a 30 percent decrease during exam periods, which confirms that stress can cause a temporary decline in the sperm count.

Foul air hits below the belt

Calcutta’s male population is losing the power to procreate with every breath of foul air, according to an Indo-American study of infertility patterns in the city over two decades.

Toxic fumes belched out by vehicles are not only responsible for sore throats and damaged lungs and hearts but also “a significant decline” in male fertility since the 80s, says the report on the basis of laboratory studies of sperm samples collected more than 20 years apart.

The report — the result of collaboration by researchers from Calcutta University, the Dhakuria-based Advanced Medicare & Research Institute (AMRI) and Cleveland Clinic, Ohio — twice refers to The Telegraph’s campaign against vehicular emission.
“It was a first-of-its-kind study in the subcontinent and has been accepted for publication in Fertility and Sterility, a research journal of the American Society for Reproductive Medicine,” said a scientist associated with the project.

The examination of 3,729 sperm samples — 1,752 in the 80s (1981-85) and 1,977 in the last decade (2000-07) — revealed a nearly 10 per cent drop in semen volume and a corresponding decline in motility (a measure of the percentage of sperm that can move towards an ovum for fertilisation) over 20-odd years.
“In the last two decades, fertility patterns in the city have undergone tremendous changes and we found a strong correlation between the trend and worsening pollution levels in the city,” said Ashok Bhattacharyya, a retired professor of biochemistry at Calcutta University and a co-author of the paper.

Dyutiman Mukhopadhyay, the first author of the paper, and the other scientists had taken care to avoid “regional variation” in the selection of samples. According to the report, the root cause of male infertility was regular inhalation of noxious gases belched out by polluting vehicles and the increasing presence of heavy metals such as lead and cadmium in the environment.

The experts attributed the decrease in semen volume mainly to chemicals that adversely affect male sex hormones. Several studies have established that these toxins — released in the air mainly by polluting vehicles — directly affect the functioning of “accessory sex glands” that help produce sperm.
“Benzopyrene, an extremely toxic and carcinogenic pollutant found in the city’s air, can break through all membranes and damage sperm,” Bhattacharyya said.

Alex C. Varghese, the scientific director of the in-vitro fertilisation division of AMRI and a co-author of the study, said the changes in infertility patterns were significant because “such a decline has taken place in a very short duration”.

The paper quotes a World Bank study as saying that in 2002 Calcutta was the third most polluted city in the world in terms of concentration of particulate matter. “Transport emissions in Calcutta rose from an estimated 1,825 tonnes per annum in 1970 to 25,550 tonnes in 1990.”
The paper quotes from reports in The Telegraph to illustrate how much autorickshaws and adulterated fuel (katatel) have contributed to air pollution.

Sudarshan Ghosh Dastidar, an expert on fertility research, said the “male factor” in infertility had shot up to 45 per cent from 30 per cent about four decades ago. He warned that the male population was more vulnerable to air pollution because of lifestyle and frequent exposure. “Sperms generally take 70 to 80 days to mature and males are extremely vulnerable to air pollution during this particular period,” Ghosh Dastidar added.

source: telegraphindia.com

Vietnam has made significant progress in infertility treatment

Recent achievements in infertility treatment in Vietnam have not only given fresh hope to childless couples, but also earned the country international recognition, according to local experts.

In the last week of December, the Hanoi-based Military Hospital’s Embryo Technology Center announced its success in culturing spermatids, saying that a baby had been born and six were expected to be born this year using the method.
Although the success rate now stands at 10 percent, it is notable that Vietnam is the first country in Asia to succeed in developing the technique, Vietnam News recently quoted Quan Hoang Lam - head of the center as saying.

Initiated by Doctor Tesarik J. from Turkey in 2001, the new technique helps men who cannot produce sperms.
Men can have their spermatids – the cells that become spermatozoon (sperms) – grown into sperms in culture medium within 24 hours and then injected into their wives’ ovum for fertilization.
Leading IVM nation
“Vietnam is one of the five countries, including Canada, Japan, the Republic of Korea and Italy, which are leading in developing in vitro maturation (IVM),” Ho Chi Minh City Reproductive Endocrinology and Infertility Association (HOSREM) General Secretary Dr. Ho Manh Tuong told Lao Dong in a recent interview.
Since the first IVM baby was born in 2007, it is estimated that Vietnam has introduced 4 to 5 percent of some 500 IVM babies that are delivered internationally, he says.
“The number of IVM babies in Vietnam has increased sharply thanks to the rather high success rate,” Tuong adds.
According to HORSEM statistics, around 50 pregnancies so far have been achieved using IVM, including more than 10 cases of twins.
Following the success of the Vietnamese program, local scientists and experts have been invited to report their IVM application at international conferences, including the first European IVM meeting held in Monza, Italy, last month, Tuong says.
The association has also been invited to take part in a multi-center study on
IVM babies in the world headed by Professor R. Cheng Chian and Professor Seang Lintan of McGill University in Montreal, Canada, he says.
During IVM, immature eggs, or oocytes, are retrieved from the ovary, then matured in the laboratory before being fertilized and implanted in the womb.
The method almost halves the cost of In Vitro Fertilization (IVF) and has a shorter time of 10 days instead of four weeks.
Moreover, it does not imply a potentially fatal side-effect of injections given to stimulate egg production prior to retrieval, like the IVF. The side-effect, which is very rare, is known as the Ovarian Hyperstimulation Syndrome.
While new achievements are being recorded and newer techniques applied, Vietnam already has a solid base in IVF development, experts say.
The country marked its first achievement in infertility treatment when three babies were born in 1998 using the IVF technology.
Over the past 10 years, 10 IVF centers have been established nationwide and these have introduced nearly 5,000 IVF babies in Vietnam, Tuong told the Sai Gon Giai Phong newspaper recently.
Since 2004, Vietnam has also conducted IVF courses for foreign students from countries like Thailand, Indonesia, Malaysia and Myanmar.

Source: Lao Dong, SGGP