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Over at Revolution Health, Tara Cousineau, PhD, has commented on recent reports about an upcoming article in Science. The article will give more voice to fertility patients regarding the question of what to do about the embies...
Link: Embryo donation: Voice of patients - Blogs - Revolution Health.
I admire Nature, the work they do, service they perform. But, well, maybe I'm just a tad sensitive of late -- please don't ask the people who know me best, they'll only nod their heads and walk away muttering -- or perhaps I should just put that partition up again, the opaque one that I built in 2001 when it became clear to me that my audience really gives fewer than two whits about stem cell news... At any rate, here I go again, feeling left out on behalf of the creators of stem cells.
So, I hear about a new site by Nature, tightly focused on all-things-stem-cells. Some of you know me well enough to recall my stance that the first area of a site worth visiting is the About Us page. The new site, called Nature Reports Stem Cells, includes some heavy hitting commentary and reporting on the related science, research, politics, and society ramifications. It's packaged neatly, too, warmer than a deep science site usually appears. Pretty, even.
But here's the rub -- for me. Could be only me. I get that. But here it is, from their About page... "Our goal is [to] enlighten and promote communication in stem cell research by providing content as diverse as the stakeholders in this field—all the scientists, policy makers, ethicists, clinicians, and patients who are driving stem cell research forward."
So, just to clarify -- are the people who are making the hundreds of thousands of embryos that could be culled for use by this science being lumped into the stakeholder category of "patients"?
True, the broad topic of "stem cell" isn't only about those derived from the embryos about which I'm concerned. But really... a lot (most?) of the politics of this science is indeed derived from the heated debates related to life, when it begins, and within which frame we should view these embryos lying frozen in cryo facilities around the U.S.
When I read the mission sentence above from Nature Reports, I hear "patients" to mean the people who will likely wind up benefiting the most from stem cell research -- individuals and groups with certain conditions that can possibly be rectified with treatments and cures from stem cell research and development. I don't hear "infertility patients" within that text.
Maybe I'll find what I'm looking for once I take a deeper gander at the site. I'm hoping to find some real addressing of the issues as they relate to the people who are, at this moment, creating tens of thousands more embryos that will be added to the stockpile.
At this point, a solid seven years after I first wrote about connecting the baby-making-cum-stem-cell-creators with the decision makers and hearing the font fall with a silent thud on the cyber copyroom floor, I'd be appeased by even just a mention of this group's existence.
But again, maybe it's just me.
Just to prove that I actually do climb out of my workpile now and then...
It's amazing what the struggle to procreate can help you come up with.
The International Infertility Film Festival
Sorry to have taken so long, Bea.
I was recently asked for my opinion on the newly FDA-approved home fertility test for men and women called Fertell. For about a hundred bucks, you can get an FSH test for women and a semen concentration/sperm motility assessment for men.
The key marketing point is, of course, privacy. I know how important that can be to men, especially. Given the choices, I'd rather take a blood test than masturbate in a clinic, any day.
The problem -- Fertell renders answers to only about three of the myriad questions at work in the whole infertility mystery.
Sure, it matters how many sperm cells there are in his semen and, yes, how those guys move can be crucial to their journey. Granted, both of those things, if they're the only problem, are pretty easily corrected for, even with fairly conventional treatment like IUI. And neither concentration nor motility is nearly as important as morphology, that is, the shape of sperm cells. But it's always good to have an idea, I guess, of those basic parameters.
The bigger problem, in my opinion, is the FSH measurement and, importantly, how such a measure and its impact on fertility are portrayed in the literature provided. Now -- a caveat -- I've not seen the accompanying literature for Fertell. But I've read some of the press put out on the product's US launch.
And this is why I've posted this in the category "Shopping For ART", as opposed to the more fertility-basic "Why Am I Here?" on this blog: by the time a consumer has access to the fine print, even if it's wonderfully educational, they've purchased the product. Sure, there are likely good return policies if the buyer's dissatisfied, but how many of us go through the trouble? The stuff that's more likely to be steering folks to buy are the "news reports", often based on manufacturer press releases.
Take, for example, US News & World Report's write-up in which Deborah Kotz refers to FSH as a hormone that "rises as a woman nears menopause."
Well, yes. And no.
FSH can also rise when a woman is under extreme stress. Or when she has certain untreated or poorly treated health conditions. A 20-something year old woman with a high FSH isn't necessarily always "near" menopause.
Similarly, men should be informed of the simple yet profound fact that their bodies, when functioning optimally, are constantly making new sperm cells (unlike women, who do not make new oocytes during their lifespan... we think...) So, any single test of this particular kind -- the FSH for women and the SA for men -- actually renders nothing more than a snapshot into continual processes that can sometimes ameliorate themselves with or without conscious effort.
In her second book, incredibly titled The Fertile Female: How the Power of Longing for a Child Can Save Your Life and Change the World, the once-FSH-challenged Julia Indichova (who went on in her 40's to conceive her second child naturally) expresses hope that her older readers especially will feel their commitment strengthened "to pursue motherhood without succumbing to the collective hysteria of the last good egg."
Oversimplification of the complex facts about reproductive hormones and cell parameters can sometimes fuel the fires of that collective hysteria. I'm interested in seeing how the test kit does on the market.
Link: Health : New Home Screening Test for Infertility - US News and World Report.
In the "Where Do We Go From Here?" department... reproductive scientist Jonathan Tilly had to back-pedal a tad from his enthusiasm over 2005 research in which sterile mice wound up making immature oocytes following bone marrow transplants. Turns out, according to subsequent explorations, that fertilizable eggs were not resulting from bone marrow stem cells.
But another study is due out soon, in Journal of Clinical Oncology, that points to restored fertility following bone marrow transplant -- but not from donor stem cells.
Tilly is cautiously optimistic. But the most interesting comment on the findings are from John Eppig at Jackson Labs, who says that while this research may not do a thing for infertility patients, "In the end, we're probably going to learn a lot about the essence of what it is to be an oocyte..."
No great surprise, but documented evidence of hunches is always good. Last week, the Human Fertilisation and Embryology Authority in the UK published statistics that show a ten-fold increase in the use of fertility treatment by women in their 40's in the last 15 years.
As Ken Abbott of IntegraMed America put it in an email, "Gotta love 'population aging', which will have a huge socio/economic impact this century."
Sure, you gotta. No choice there. Readers must know that I use the flippant term "old folks" in the sub line with nothing but love in my heart, being the gray-haired mom of an elementary schooler.
Abbott also wondered aloud if such a huge shift has been seen on this side of The Pond, which may partly explain the surge in Internet interest for info on tubal reversals and donor egg treatment. Good question. Let's find out.
Link: Tenfold rise in fertility treatment for over-40s | Health | SocietyGuardian.co.uk.
