Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, August 14, 1994 TAG: 9408150064
SECTION: VIRGINIA PAGE: E-8 EDITION: METRO
SOURCE: Associated Press
DATELINE: NORFOLK LENGTH: Medium
One of the women treated at the school's Jones Institute for Reproductive Medicine miscarried, but seven of the 14 women who received fertilized eggs remain pregnant, including one with twins and one with triplets.
The latest high-tech procedure, called intracytoplasmic sperm injection or direct sperm injection, is used in cases in which the man is unable to father children because of weak or insufficient numbers of sperm.
``It is great, modern technology. It's amazing,'' said one of the expectant mothers, a 28-year-old in Connecticut who asked to remain anonymous so friends would not know her husband is infertile. ``We're expecting twins. I haven't seen actual babies yet; I've only seen little black blobs [on an ultrasound]. But they had heartbeats.''
The first ICSI (pronounced ICK-see) baby in the United States was born last September. The first Jones Institute ICSI baby is due around the first of the year. The Genetics and IVF Institute in Fairfax also is performing the procedure.
The process was tried at Jones in 1988, but no pregnancies resulted, and it was abandoned in favor of more promising techniques, said Dr. Suheil L. Muasher, director of in-vitro fertilization at the Jones Institute. A clinic in Belgium perfected the technique, however, and has produced more than 100 babies using it.
ICSI is expensive - $2,000 on top of the usual in-vitro fee of $5,000 to $7,000 for each attempt. The Connecticut couple spent about $27,000 on three attempts to get pregnant.
But, using ICSI, Jones has now achieved fertilization rates of 65 percent, higher than the rates for other in-vitro methods, and implantation rates (where the embryo attaches to the uterus) of 24 percent, double the usual figure.
``We were amazed by this,'' Muasher said. ``We were extremely excited about this.''
Because ICSI is technically challenging, few clinics can do it at this point. It is used mainly for couples in which the man is infertile, which reduces the chances of other in-vitro techniques working.
Dr. Masood Khatamee, executive director of the New York-based Fertility Research Foundation, said ICSI is ``a breakthrough.'' It is too early to determine success rates for ICSI, but rates for any in-vitro technique vary widely among clinics, he noted, depending on how good they are.
Regular in-vitro fertilization involves placing an egg into a lab dish, then dropping thousands of sperm on top of it. Only one sperm is needed to penetrate the egg and fertilize it.
ICSI capitalizes on those odds, using a tiny needle to capture one sperm, then helping it penetrate the egg. Three fertilized eggs are placed in each woman's uterus, improving the chances that at least one will attach and grow into a baby.
Nearly half of all infertility can be traced to men, despite society's common view that infertility is a woman's problem. Normal sperm counts are around 12 million, but the men whose sperm are used in ICSI have average counts of 8 million, Muasher said.
Muasher said he believes ICSI will make male infertility more accepted. ``It's a very common problem, and I think one of the things in vitro has helped us to do is understand the male better,'' he said. ``This is probably the biggest single cause of infertility. ... Up to very recently, we could do very little about it.''
by CNB