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Experts hail gains in fertility treatment

By Warren King Seattle Times medical reporter


More than 177,000 babies have been delivered in the United States using reproductive technologies that started 20 years ago, researchers in Seattle said yesterday. But in talking about all that has been achieved, they also criticized federal action that for now has halted development of some new technologies.

In the past two decades, technology has dramatically expanded and Enabled the pregnancy rates for women undergoing the procedures to reach 25 to 50 percent. At the same time the number of multiple pregnancies among those undergoing the procedures has declined sharply.

"We have new ways to help couples achieve their goals," said Dr. James Toner, an Atlanta endocrinologist who reported on the advances to the American Society for Reproductive Medicine.

More than 3,000 reproductive specialists are gathering through Thursday For the 58th annual meeting of the society at the Washington State Convention and Trade Center.

While Toner cited progress in the technology, he and other officials Roundly criticized the Food and Drug Administration for effectively banning certain technologies a year ago. The agency said it was concerned about safety and issued the ban during the heat of ontroversy over cloning and the death of a patient undergoing gene therapy.

The FDA says any treatments that genetically alter egg cells or embryos would fall under its jurisdiction and, like drugs, require extensive review and approval. Previously, the agency had stayed away from fertility procedures because its policy is not to interfere with the practice of medicine.

The action for now has stopped an experimental procedure in which Material from a young woman's egg is added to the egg of an older woman in an effort to increase the chance of pregnancy. The material contains DNA, so the egg would end up with genes from three parents. Also topped was a procedure in which the nucleus of a donor egg is transferred to the egg of a woman seeking to become pregnant.

"The FDA has now gone from regulating food, drugs and medical devices to regulating the practice of medicine. ... Their concern is safety. Our concern is safety," said Dr. Jamie Grifo, a New York University School of Medicine endocrinologist and president of the Society for Reproductive Technology, an affiliate organization.

Grifo said researchers never knew for certain about the safety of in Vitro fertilization and other technologies until they were tried on humans. "Patients must take some risk (with new procedures)," he said at a news conference.

Toner said the most successful technology to date, with a 50 percent pregnancy rate, involves implanting a donor egg fertilized with sperm of the patient's partner. The cost is $5,000 to $7,000. In vitro fertilization involves mixing the egg and sperm in a lab dish, then implanting the egg. The procedure, which has been used in the U.S. since 1985, costs $8,000 To $15,000 and has a 35 percent pregnancy rate.

A small survey of parents conducted by Cornell University and University of Oregon researchers found that some children of two reproductive technologies were at risk, around age 3, for developmental problems involving communication, gross motor (muscle) skills, fine motor skills, problem solving and personal-social skills.

About 16 percent of children conceived by in vitro fertilization (IVF) Were at risk for problems. And 14 percent of those from ICSI (intracytoplasmic sperm injection, in which a sperm is injected into an egg, then implanted) were at risk. About 10 percent of 3-year-olds in the overall population are at risk.

However, the researchers said only 18 percent of about 1,400 parents returned questionnaires about their children. They said none of the children had problems significant enough, under federal guidelines, to require special services at that age.

Another survey by University of Sydney (Australia) researchers found That mothers of 179 5-year-olds conceived by IVF or ICSI had more protective attitudes toward their children than the mothers of 113 children conceived naturally. They also found that the children of the reproductive technologies behaved and developed just as well as the other kids, according to parents and teachers.

"Thus, the differences identified in ... maternal attitudes do not appear to impact adversely on child adjustment," the researchers reported. "Indeed, they may reflect a heightened awareness of and sensitivity towards their child, related to the unique path to conception."