Are IVF pregnancies more ‘precious’?


Two pregnant women

Do women with IVF pregnancies need special attention?

  • Women who have gone through fertility treatment often say it had a huge emotional and psychological impact on them and their partners.

In many cases, couples have spent years trying to conceive before going through several cycles of IVF, which can be expensive and traumatic, with no guarantee of success.

So are pregnancies achieved through assisted fertility treatments viewed as inherently more precious to everyone involved?

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“Until you go home with your baby in your arms, that anxiety is always there.”

Susan SeenanInfertility Network UK

A study from Plymouth University published last month suggests they are. Dr Yaniv Hanoch asked 160 Israeli obstetricians and gynaecologists whether they would recommend a test for a serious medical condition during pregnancy.

He found that doctors were three times more likely to recommend the test, which carried a small risk, for a natural pregnancy than for an IVF pregnancy.

Dr Hanoch, associate professor in psychology, said: “When considering a procedure that may endanger a pregnancy, the value ascribed to loss of that pregnancy may seem greater if the pregnancy was achieved by tremendous effort.”

In 2005, Minkoff and Berkowitz published a study in the American journal, Obstetrics and Gynecology entitled ‘The Myth of the Precious Baby’.

It said that because increasing numbers of pregnant women were aged over 40 and more were pregnant thanks to assisted reproductive technologies, this had resulted in more ceasarean deliveries, reinforcing the idea among obstetricians that they were dealing with ‘precious babies’.

Ante-natal check up
IVF women often want reassurance on aches and pains during pregnancy

On the ground, there is less evidence of sensitivity and understanding from health professionals towards women with IVF pregnancies.

Susan Seenan, from the Infertility Network UK, says the system lets these women down.

“When these women finally go to their GP and say they are pregnant, they are referred for ante-natal care and that’s it.

“Even when they make it known they have had IVF, they are seen as just another pregnant lady.”

She says sometimes even when women reveal they have suffered miscarriages or have had fertility issues, there is a lack of sympathy.

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Some women like to feel they have access to extra information as required, even if it’s just a phone number to speak to a midwife about any aches or pains.”

Mr Tim ChildOxford Fertility Unit

She says fertility treatment is widely recognised to be a physically, psychologically and financially demanding process – and it can leave women feeling they have been on an ’emotional rollercoaster’.

“A lot of women feel very anxious, because they have been through so much, and many women really do worry that everything will be OK.

“Until you go home with your baby in your arms, that anxiety is always there. People need to understand why they are feeling vulnerable and anxious.

“If they have been through the IVF system they will have had a lot of attention, appointments, blood tests and scans – and they expect that attention to continue.”

Instead, many women are left feeling isolated when they are most in need of reassurance.

Seenan says this could be remedied by providing support in the form of a phoneline to call in times of anxiety or information leaflets to read.

Research does seem to confirm higher levels of anxiety in women with IVF pregnancies, says Julie Jomeen, professor of midwifery at Hull University, who adds that their feelings can mean they want a more medicalised approach to their pregnancy.

Older mums-to-be may request a caesarean section delivery, believing that it is safer, for example.

An obstetrician discussing options with a pregnant womanSome women choose not reveal they had fertility treatment

Or a woman who is scared of losing her baby throughout pregnancy, may need reassurance that normal symptoms of pregnancy, such as backache, are not something more serious.

Mr Tim Child, medical director at the Oxford Fertility Unit at the University of Oxford, acknowledges that women who have conceived naturally can have anxieties too, but he says it would be understandable if IVF women felt they needed more support.

“Some women like to feel they have access to extra information as required, even if it’s just a phone number to speak to a midwife about any aches or pains.”

He says not all women want to disclose that they have been through IVF because there is still some stigma attached to it. Others may want to be treated the same as every other woman, so their IVF history may not always appear on their personal notes.

Medically, there are slightly higher risks of complications in IVF pregnancies, particularly if the woman is older, has underlying health problems or is having twins, so Mr Child says consultants should be vigilant.

A study is currently underway at Oxford into how midwives care for women have had fertility treatment.

When women with IVF pregnancies are open about their anxieties, what they are looking for is not special treatment in the belief that their baby is more precious than anyone else’s, but reassurance and support during the final stages of a long and emotional journey.

Even when the baby is born, it doesn’t end, Susan Seenan says.

“Because the baby has been wanted for so along, you put pressure on yourself to be a perfect parent. So you’re not allowed to complain when it cries at night or doesn’t feed well. But in the end, we are just parents like anyone else.”

Plastic fibre a ‘major pollutant’


Tiny pieces of plastic and man-made fibres are causing contamination of the world’s oceans and beaches, the journal Science has reported.

Even remote and apparently pristine layers of sand and mud are now composed partly of this microscopic rubbish, broken down from discarded waste.

Plastic bottles on a beach, Science

This is the first assessment of plastic fragments accumulating in sediments and in the water column itself.

It is not yet known what the long term effects of this pollution may be.

A team led by scientists at the universities of Plymouth and Southampton took samples from 17 beaches and estuaries around the UK, and analysed particles which did not appear to be natural.

The researchers found that most samples included evidence of a range of plastics or polymers including nylon, polyester and acrylic.

 

It suggests to us that the problem is really quite ubiquitous

They also found that when creatures such as lugworms and barnacles fed on the sediments, the plastics turned up inside their bodies within a few days.

To test whether this contamination was getting worse, the scientists analysed plankton samples taken from survey ships between Scotland and Iceland since the 1960s – and found that the plastic content had increased significantly over time.

Toxic chemicals

Because the team only sampled particles which looked different from natural sediments, it is believed that the true level of plastic contamination could be much higher.

The lead author of the study, Dr Richard Thompson, said: “Given the durability of plastics and the disposable nature of many plastic items, this type of contamination is likely to increase.

 

Rocket casing on a beach, Thompson/Science

This rocket casing is one of the more unusual pieces of litter on the world’s beaches

“Our team is now working to identify the possible environmental consequences of this new form of contamination.”

One concern is that toxic chemicals could attach themselves to the particles which would then help to spread them up the food chain.

That research is for the future, but this study suggests that practically everything really is made of plastic these days – even the oceans.

“We’ve found this microscopic plastic material at all of the sites we’ve examined,” Dr Thompson said.

“Interestingly, the abundance is reasonably consistent. So, it suggests to us that the problem is really quite ubiquitous.”

Accumulating ‘microplastic’ threat to shores.


Debris on shoreline (Image: AP)
Concentrations of microplastic were greatest near coastal urban areas, the study showed

Microscopic plastic debris from washing clothes is accumulating in the marine environment and could be entering the food chain, a study has warned.

Researchers traced the “microplastic” back to synthetic clothes, which released up to 1,900 tiny fibres per garment every time they were washed.

Earlier research showed plastic smaller than 1mm were being eaten by animals and getting into the food chain.

The findings appeared in the journal Environmental Science and Technology.

“Research we had done before… showed that when we looked at all the bits of plastic in the environment, about 80% was made up from smaller bits of plastic,” said co-author Mark Browne, an ecologist now based at the University of California, Santa Barbara.

“This really led us to the idea of what sorts of plastic are there and where did they come from.”

Dr Browne, a member of the US-based research network National Center for Ecological Analysis and Synthesis, said the tiny plastic was a concern because evidence showed that it was making its way into the food chain.

“Once the plastics had been eaten, it transferred from [the animals’] stomachs to their circulation system and actually accumulated in their cells,” he told BBC News.

In order to identify how widespread the presence of microplastic was on shorelines, the team took samples from 18 beaches around the globe, including the UK, India and Singapore.

“We found that there was no sample from around the world that did not contain pieces of microplastic.”

Scanning microscope image of nylon fibres
The smallest fibres could end up causing huge problems worldwide

Dr Browne added: “Most of the plastic seemed to be fibrous.

“When we looked at the different types of polymers we were finding, we were finding that polyester, acrylic and polyamides (nylon) were the major ones that we were finding.”

The data also showed that the concentration of microplastic was greatest in areas near large urban centres.

In order to test the idea that sewerage discharges were the source of the plastic discharges, the team worked with a local authority in New South Wales, Australia.

“We found exactly the same proportion of plastics,” Dr Browne revealed, which led the team to conclude that their suspicions had been correct.

As a result, Dr Browne his colleague Professor Richard Thompson from the University of Plymouth, UK carried out a number of experiments to see what fibres were contained in the water discharge from washing machines.

“We were quite surprised. Some polyester garments released more than 1,900 fibres per garment, per wash,” Dr Browne observed.

“It may not sound like an awful lot, but if that is from a single item from a single wash, it shows how things can build up.

“It suggests to us that a large proportion of the fibres we were finding in the environment, in the strongest evidence yet, was derived from the sewerage as a consequence from washing clothes.”

Plastic ‘a threat’ to biodiversity


Microplastics ‘pose toxic threat to marine biodiversity’

Micro plastic
An estimated 150 million tonnes of plastic is “lost” each year

Tiny particles of waste plastic that are ingested by shoreline “eco-engineer” worms may be negatively affecting biodiversity, a study says.

So-called microplastics may be able to transfer toxic pollutants and chemicals into the guts of lugworms, reducing the animals’ functions.

An estimated 150 million tonnes vanishes from the global waste-stream each year.

The findings have been published in the academic journal Current Biology.

“We are losing a large volume of plastic and we know it is going into the environment and the assumption being made by policymakers is that this material is non-hazardous, it has got the same ranking as scraps of food,” explained co-author Mark Browne, an ecologist from the US-based National Center for Ecological Analysis and Synthesis.

“The research we have done really challenges that,” Dr Browne added, referring to the findings of lab work carried out by colleagues at Plymouth University, UK, led by co-author Prof Richard Thompson.

“Our findings show that the plastic itself can be a problem and can affect organisms.

“Also, when particles of plastic go into the environment what you find is that they accumulate large quantities of pollutants that are banned. So you have these particles themselves but also a load of nasty chemicals.”

Important role

The team found that the tiny bits of plastic, which measure 1mm or smaller, transferred pollutants and additive chemicals – such as flame-retardants – into the guts of lugworms (Arenicola marina).

This process results in the chemical reaching the creatures’ tissue, causing a range of biological effects such as thermal stress and the inability to consume as much sediment.

Dr Browne explained that this had consequences for the surrounding ecosystem.

“If the animals are not able to eat as much then there is a change in the function of the organisms and there is an impact on the semblance of the species found in an area,” he said.

He added that the worms had earned the nickname “eco-engineers” as a result of their ability to eat organic matter from the sediment and prevent the build-up of silt.

“Through that process, it produces burrows and changes the whole assemblage of animals that live around it,” Dr Browne observed.

“This is quite considerable because if you look at the total biomass of a shoreline, about 32% can be made up from these organisms.”

He told BBC News that it was the first study of its kind to highlight the toxic risk posed by microplastics to marine organisms.

“For about 40 or 50 years, we have been finding very large concentrations of chemicals in animals. Then they started to find animals with larger concentrations of pollutants and plastics, so researchers began to establish this correlation.

“But no-one had actually shown whether chemicals could transfer from plastic when they are eaten by animals and accumulate in their bodies and reduce important functions that maintain their health.”