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Egg donor expenses  2010-09-01 03:54:58

 

The body that regulates fertility treatment in the UK is considering increasing compensation for egg and sperm donors.

Women who donate eggs are currently paid £250, but this could rise considerably under moves to address egg and sperm shortages at IVF clinics.

Many fertility clinics have long waiting lists, driving some childless couples abroad.

No decision will be made until the end of a public consultation next year.

A spokesperson for the Human Fertilisation and Embryology Authority (HFEA) told the BBC: "We will be looking at a number of issues related to donation policies, one of which will be compensation given to donors. We haven't decided on a figure."

The HFEA is holding a three-month public consultation into its donation policies, starting in January 2011.

It follows concern over the number of Britons travelling to countries such as Spain to receive IVF because of shortages of donated eggs and sperm in the UK.

In the UK, egg and sperm donors cannot be paid but can claim "reasonable expenses" for travel and loss of earnings.

This is limited to a maximum of £250 per cycle of egg donation or course of sperm donation.

Some fertility experts say this is too low to attract donors, and they should be paid more for their time and efforts.

Waiting list

Reports have suggested around £800 or more per cycle of egg donation but this has not been confirmed.

Susan Seenan of the support group, Infertility Network UK, which helps infertile couples, said it was right to look at all the policies surrounding egg and sperm donation.

She said: "We know that many patients are travelling abroad for treatment, often because of the severe lack of sperm and egg donors in the UK.

"Although many patients do receive a high standard care abroad, this is not ideal and the rules and regulations in other countries can be totally different from that in the UK."

She said patients deserved access to safe, regulated treatment in their own country, and there was a need to find some way of increasing the number of both sperm and egg donors in the UK.

Via: bbc.co.uk

The Evolution Of Eggs And Sperm  2010-09-01 03:54:31

 

Have you ever wondered why most sexually reproducing organisms have two contrasting sex cells: big, immobile eggs in females and plenty of small motile sperms in men? Scientists have at last disclosed the secrets behind the reproductive science.

James Umen and colleagues at the Salk Institute for Biological Studies in California, examined related algae – the single-celled Chlamydomonas reinhardtii and the multicellular Volvox carteri, which diverged from each other 200 million years ago.



Both types are known to reproduce sexually under certain conditions. While V. carteri reproduces through the fusion of a large female egg and small male sperm, C. reinhardtii's sex cells are of a same size and cannot be categorized as male or female.

The process in each case is controlled by a genetic sequence known as the Mating Locus, or MT, which the researchers hoped would yield clues as to why the sex cells produced by the two types of algae are poles apart.

The researchers compared the MT regions of both algae by examining the RNA sequences produced by each. They found that although V. carteri's genome is just 17 per cent bigger than that of C. reinhardtii, its MT region is five times larger.

Although, some of the genes identified were common to both, the team identified five new genes present only in V. carteri's female MT and eight new male genes.

Crucially, although these are completely new, the team found similar genes with non-sex roles close to the MT area in the genome of C. Reinhardtii. It looks as if Volvox had translocated these genes into its MT area, and over time they have gained new functions related to sex.

"The genes evolve rapidly in sex-specific ways," said Umen, who believes they accumulate mutations over time. A beneficial mutations must have lead to larger eggs and smaller, plentiful sperm.

Via: living.oneindia.in

 


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Introduction
The key to our similarities and our uniqueness are in the strings of nucleotides that compose our DNA. A set of such strings that may independently code for a functional or structural component (which may either be a polypeptide or RNA) is called a gene. These genes are the units of heredity which represent a blueprint of our physical and physiological possibilities and limitations.

Since the discovery of double helical structure, there has been a tremendous expansion of scientific knowledge in human genetics. Advancement in sequencing technologies have resulted in generation of enormous data on sequence and physical mapping of nucleotides while progression in transgenic and knock-out techniques has helped in an increased understanding of these sequences. These techniques have allowed scientists to learn a great deal about how genes work and how and which genes are linked to a given disease. As more and more number of these genetic associations is being identified, the number of available genetic tests that detect genetic disposition to those diseases has also increased proportionately.

A genetic test is basically the analysis of human genetic components at various levels of organization – be it small stretches of DNA or the highly organized chromosomes, in order to detect alterations related to a heritable disorder. Genetic tests can be done on practically any biological sample from which DNA can be isolated. These tests can be accomplished by various ways – directly examining the stretch of DNA, linkage analysis by looking at markers co-inherited with a disease-causing gene, or cytogenetic testing examining the chromosomes.
Genetic test are usually done for a number of different reasons which include, but are not limited to, finding possible genetic diseases in unborn babies, screening embryos for a familial disorder, confirming diagnosis in adults, to help in family planning, in cases of legal disputes pertaining to validation of maternal or paternal relationships and even in diverse forensic studies! The number of application areas is just enormous!

Since genetic testing may open up many ethical or psychological concerns, such form of testing is often done in guidance of a counselor whose role is to help people in understanding the results and make better and informed decisions.

Types of Genetic Testing:
Genetic testing can be applied in diverse settings but other than legal issues of inheritance, parentage or forensics, most of these tests are applied in a clinical setting. Clinically applicable genetic tests may be used for diagnostic testing, predictive and presymptomatic testing, carrier testing, prenatal testing, preimplantation testing, and newborn screening.

Diagnostic testing:
This form of testing is used to identify, confirm or rule out a specific genetic or chromosomal condition in a symptomatic individual. While this diagnostic testing may not be available for all genes or all genetic conditions, it may not be definitive for certain conditions for which it is available. Often, before making a conclusive diagnosis, physicians may use genetic testing to provide secondary confirmation to the results of a biochemical assay or when a particular condition is suspected based on signs and symptoms for a specific disorder. DNA testing may yield more accurate diagnostic information at a lower cost in certain cases. Often, when accompanied with proper counseling, such diagnostic tests can greatly influence a person’s outlook towards health care & disease management.

Newborn screening:
This type of screening is done right after birth in infants who have an increased chance of having a specific genetic disorder so that appropriate treatment can be started before it’s too late. There are newborn screening programs for a set of diseases in different countries and millions of babies are tested each year under such programs. For instance, all states in America test newborn babies for various endocrine, hemoglobin, cystic fibrosis and metabolic disorders with an aim to identify infants who need immediate therapeutic intervention to prevent developmental or other potentially debilitating or fatal disorders. Proper counseling and educating parents is necessary in case of positive screening results in order to avoid misunderstandings, anxiety or discrimination.

Carrier Testing:
This form of testing is used to identify people who carry at least one copy of a mutated gene or allelic variant that, when present and expressed doubly, may cause a physiological or metabolic abnormality. It is difficult to identify carriers as such because they are usually asymptomatic and do not manifest symptoms associated with the mutation themselves. Carrier testing is offered to individuals who have a family history of a certain genetic disorder and to people in specific ethnic groups with an increased risk of specific genetic conditions. Depending on carrier status of parents for a given genetic condition, this test can assess a couple’s risk of having a child with the same condition. So, it allows for informed reproductive choices and careful family planning.

Predictive and presymptomatic testing:
These forms of testing are offered to asymptomatic individuals for detection of established genetic mutations or allelic variants that are well associated with certain disorders which are often late-onset i.e. they manifest later in life. Various personalized genomics services nowadays are predictive and pre-symptomatic forms of genetic testing which allows timely intervention in the form of lifestyle changes or therapeutics that may further delay the onset of certain diseases. As this form of testing can have serious ramifications, careful patient assessment, counseling, and follow-up are important. Often, such form of predictive testing for asymptomatic disorders is discouraged when no medical intervention is available.

Prenatal Testing
Prenatal testing is performed during various trimesters of pregnancy in various forms to assess the overall health status of a fetus. Genetic testing for prenatal cases is offered only if preliminary biochemical assays like triple test or ultrasonography reports something fishy or if there is a family history or carrier parent for a certain genetic or chromosomal disorder. However, prenatal genetic analysis often requires fetal cells and sampling may not be completely risk free. With this in mind, research has been directed to development of techniques that may sample circulating fetal cells in maternal serum!

Pre-implantation Testing:
Pre-implantation testing, also called pre-implantation genetic diagnosis (PGD) is used to test cells of an 8-celled stage embryos, created by in-vitro fertilization, for presence of certain mutations or allelic variants at suspected loci followed by selective implantation of one of only those embryos which do not possess suspected mutations. It is done to decrease the chance of a particular genetic condition in cases of multiple terminated pregnancies or abortions, strong family history of a specific genetic condition or if parents are known carriers for that condition.

Ethical aspects associated with genetic testing:
With every passing day, genetic testing is becoming more and more popular both for clinical as well as non-clinical legal and personal applications. However, since its inception, genetic testing has remained controversial for one or the other reasons, primarily for the social and ethical concerns associated with it. Some of the ethical aspects associated with genetic testing include, but are not limited to:

  • All forms of scientific testing, including genetic, needs to be done with proper informed consent of the individual. In other words, the test subject is required to be informed of the risks, benefits, results and every possible detail about the test.
  • The decision to take any particular genetic test should be entirely up to the individual and free from any sort of external pressure.
  • The ethics of genetic testing also calls for complete privacy of the test subject. The results of a genetic test are the test subject’s property and should not be disclosed to anyone without his or her consent.
  • Another ethical concern is the possible breach of privacy when you are an in-patient & taking a genetic test for which an insurance company is paying (lucky!) and the moment you sign that re-imbursement form for insurance company, you give them a right to look into your medical records! Did we say privacy?!!
  • The genetic information must not be used for any sort of discrimination by professional agencies like insurance companies & employers, amongst others.
  • One of the major ethical concerns is regarding pre-natal genetic testing for minor genetic mutations which are of little health concern to the fetus. Someone may want to terminate a pregnancy if the fetus is carrier for a certain condition so as to eradicate possibility of that condition from her family even though the condition won’t affect the fetus itself! Is it ethical?

So, a clear comprehensive ethical policy is required to address all the open issues.

Limitations of Genetic Testing:

Genetic testing holds a great potential for the future of diagnostics and medical care. Although the benefits of genetic testing outweigh its limitations, one must still be aware of these limitations:

  • If its not pre-natal genetic testing, the physical procedural risk associated with a genetic test is almost nada! However, if it’s a pre-natal testing you need to weigh your options seriously as in case of CVS or amniotic fluid sampling there is around 1% procedural risk of error that may affect your pregnancy. In most of the cases, the risk associated with genetic testing is not physical but of emotional, social, and/or financial consequences of the test results!
  • It is also important to understand the nature and type of genetic test that you are taking and the information that it can and can not provide. While some genetic tests are confirmatory in nature, others may not be so, particularly in case of late-onset disorders. The usefulness of certain genetic tests for disorders where there is no therapy or treatment currently available is also dubious.
  • Often, these tests fail to identify or predict how severely the disease shall manifest in a person carrying a particular mutation or an allelic variant.
  • In certain cases, a genetic test cannot detect all the variations that may lead to a disease tested for! For instance, in case of Duchenne Muscular Dystrophy, the DMD gene tested for is so large that sometimes it may not be possible to detect certain pathogenic mutations. In such cases, a combination of clinical findings, biochemical assays and histo-pathological studies can confirm the diagnosis.
  • Sometimes, in case of genetic carrier testing, it may happen that an affected baby may be born to a couple who has no family history of a given condition and none of the parents is a carrier! This may happen because of a de novo mutation in the embryo during the development. In such cases, genetic analysis of parental DNA wouldn’t be much useful! So, a critical step-by-step analysis and a broad outlook are required with the complete understanding of test results to make the most out of these tests.
  • The usefulness of genetic testing in multi-factorial disorders is limited as far as definitive diagnosis is concerned. In such cases, a given pathological condition is a complex interplay of genetic components and environmental factors and the way in which these interactions cause a given disease may not be clearly understood. In such cases, a genetic test shall not give a clear yes/no answer; nevertheless, it will indicate genetic disposition to a particular condition, multi-factorial or not!
  • One final limitation – It’s not exactly a limitation of genetic testing but of insurance covered health care system in United States that has never been able to figure out how to get predictive and preventive testing services covered! Until those things are covered for outpatient services, there will be a fiscal barrier in front of those who might want this information but can’t afford to have it!

These limitations make genetic tests a mixed blessing and the decision to take any such test should be based on complete understanding of that test and on what you want to do with the test results! Genetic testing certainly has, and will continue to have a significant role to play in healthcare management, but the general tendency to overestimate the usefulness and underestimate the risks of these tests is potentially dangerous and must be worked upon through education and an increased awareness.