Dr Suhaimi Hassan
Salah satu 'myth' mengenai rawatan IVF adalah ianya hanya sesuai untuk pasangan yang mempunyai masalah ketidak suburan. Sebenarnya ianya juga sesuai untuk pasangan yang tidak mempunyai masalah ketidak suburan seperti mereka yang mempunyai masalah penyakit keturunan. (sila lihat dibawah antara penyakit yang telah dirawat dengan kaedah PGD)
Ada pasangan yang mempunyai penyakit keturunan atau pembawa penyakit keturunan seperti cystic fibrosis, thalassemia, haemophilia dan achondroplasia, yang boleh dibawa kepada zuriat. Akibatnya anak anak juga berkemungkinan akan mengidap penyakit sama seperti mereka.
Sebelum teknologi PGD bermula, salah satu cara untuk mengelakan penyakit keturunan yang boleh membawa maut pada zuriat ialah dengan mengelakkan dari mengandung. Satu lagi cara lain ialah dengan meneruskan kandungan sambil melakukan ujian amniosentesis atau chorionic villus sampling pada peringkat awal kandungan dari 11 hingga 16 minggu. Ujian ini melibatkan satu suntikan diperut yang bertujuan mengambil air mentuban atau mengambil sel sel chorion (sel-sel uri diperingkat awal). Sel sel tersebut akan dikulturkan sebelum dianalisakan dengan kaedah genetik untuk menentukan samada anak didalam kandungan sihat. Ujian ujian ini boleh menyebabkan keguguran(0.5%) pada kandungan apatah lagi jika kandungan itu adalah sihat. Jika keputusan ujian menunjukan bayi dalam kandungan mempunyai penyakit keturunan, maka ibu terpaksa mengugurkan kandungan. Ia boleh memberi kesan emosi yang teruk. Bagi masyarakat yang tidak boleh melakukan pengguran ia amat menyulitkan.
Kaedah PGD dilakukan sebelum implantasi embrio (kandungan) berlaku. Jadi ia dapat mengelakkan pasangan daripada melakukan penguguran dan dapat juga mengelakkan tekanan emosi akibat punyai kandungan abnormal.
Untuk pasangan melalui ujian PGD, mereka perlu melalui proses rawatan IVF walaupun mereka tidak punyai masalah ketidaksuburan. Proses ini melibatkan pasangan wanita menerima suntikan ubat untuk merangsang ovari menghasilkan telur telur yang matang. Telur yang matang akan disenyawakan dengan sperma untuk menghasilkan embrio dipiring kultur. Embrio yang terhasil akan mula membahagi kepada sel sel blastomere. Pada hari ketiga embrio dijangka punyai antara 5 hingga 10 sel sel blastomere.
Dalam proses PGD salah satu dari sel blasomere pada embrio akan diambil melalui satu proses manipulasi injeksi mikro yang rumit. Sel blastomere tersebut akan dianalisa melalui proses genetik. Dengan kaedah ini, embrio embrio yang normal dapat dikesan. Dua embrio yang normal boleh di pindahkan kedalam rahim untuk implantasi. Embrio selebihnya yang normal boleh dibekukan untuk kegunaan akan datang. Bagi embrio embrio yang punyai penyakit keturunan setelah diuji, ia tidak digunakan. Jadi penyakit keturunan dapat dielakkan
Ujian PGD juga punyai risiko tertentu. Proses mikromanupulasi embrio boleh merosakkan embrio yang diuji (0.5%). Kadang kadang embrio yang diuji tidak memberi apa apa signal genetik, maka embrio tersebut tidak sesuai diguna (5%). Kadang kadang diagnosa adalah tidak tetap. Sehingga kini terdapat 7 kes seluruh dunia yang dilapurkan dimana diagnosis genetik tidak tepat.
Kemungkinan berjaya dalam rawatan adalah dalam lingkunan 30%. Kejayaan rawatan PGD bergantung pada beberapa faktor seperti umur pasangan wanita serta faktor fertiliti.
Antara penyakit yang boleh dilakukan ujian PGD:
Achondroplasia
Alpha Thalassemia
Alzheimer (early onset)
Beta Thalassemia
Charcot Marie Tooth Neuropathy
Cystic Fibrosis
Duchenne Muscular Dystrophy
Familial Adenomatous Polyposis
Fanconi Anemia
Gaucher Disease
Haemophilia A & B
Neurofibromatosis
Osteogenis Imperfecta
Polycystic Kidney Disease
Sickle cell
Spinal Muscular Atrophy
Tay Sachs
Tuberous Sclerosis
Dan lain lain lagi (sehingga ini terdapat lebih dari 40 penyakit yang boleh diuji)
Sunday, February 24, 2008
Friday, February 8, 2008
WHY MY MIRACLE BABY WAS THE BEST CHRISTMAS PRESENT EVER
The Evening Telegraph, Friday, April 6,2007
Tom and Elaine Musson met and married in just a few weeks but, though they found love swiftly, time was not on their side when it came to starting a family. In fact, Elaine, who was in her 40s, had given up hope, especially when fertility treatment hit problems. But miracles do happen, as Wendy Roberts discovered.
WHEN Tom and Elaine Musson swapped numbers in a crowded bar, they never envisaged planning their wedding nine weeks later.
But after a whirlwind romance, the pair set a date and exchanged marriage vows. Life was looking perfect for the couple. But it’s been even better since their baby son, Jacob Alexander Gabriel, was born on Christmas Day. “We weren’t looking for love and we’d certainly ruled out ever having children,” said 44-year-old Elaine. “Now we’re married and have a lovely baby boy. It’s absolutely amazing,” she smiled. “He came on Christmas Day. He was the greatest gift we could have received. “These last months have been wonderful for us and Jacob is the most beautiful, contented baby. He’s adorable.” Elaine and Tom Musson, 46, of Scaddows Cottage, Ticknall, still cannot believe how much their lives have changed in the last three years.
Just finding each other and falling in love, they say, is nothing short of a miracle. But they believe having Jacob is their biggest achievement – especially when you hear how they needed intricate fertility treatment to get him. “Our wedding day was very quiet,” said Elaine. “We invited eight of our friends to Burton Register Office, and enjoyed a simple ceremony. Afterwards, we went to a bar for champagne. It was lovely.” Elaine and Tom started to try for a baby but it wasn’t long before they realised something was wrong. “We tried getting pregnant for a few months, and then I started thinking about my ticking body clock,” said Elaine, a psychiatric nurse. “I went to see the doctor, who ran a few tests.” News that Elaine’s fallopian tubes were blocked came as a shock. Elaine underwent treatment to try to clear them.
She said: “At my age, we were told that we’d have to pay for any kind of fertility treatment, but we had savings.” But Elaine became pregnant straightaway – and naturally. “I was over the moon,” she said. “It was great news. I could hardly believe it.” Then disaster struck. At six Weeks pregnant, Elaine had a miscarriage. The couple decided to invest £6,000 in a course of fertility treatment with CARE Fertility in Nottingham. They were advised to have IVF, where an egg is combined with sperm in a laboratory dish. If the egg fertilises, the resulting embryo is transferred into the woman’s uterus. Usually more than one egg is fertilised to give couples a better chance of having a baby. ICIS (Intracytoplasmic Sperm Injection) was also recommended. This is a procedure in which a single sperm is injected directly into an egg.
The couple were given an appointment at Derby City General Hospital, where CARE has a satellite unit. Elaine said: “It was quite daunting, because it was all so new. I felt a bit stressed because I knew time was against me. I was 43 at the time.” Almost as soon as Elaine and Tom started their first course of treatment doctors decided to abandon it. Elaine was not responding to the course of drugs she was taking and there was no chance the treatment was going to be successful. “It was a slap in the face,” said Elaine. “I was disappointed, but I knew that the doctors were right in their decision.
“We agreed to try again the following month with a higher dose of medication.” Elaine quit her nursing job to concentrate on the treatment and Tom did as much as he could to support his wife. “It was very stressful when we discovered that only one egg was good enough to be fertilised,” she said. “Some women produce loads of great eggs, but we just had one.” Elaine admits that she thought the treatment would probably fail, but piled all her hopes on her one embryo. “The doctors said it was a very healthy embryo, but I shouldn’t get too excited,” she said. “I was told to rest for two weeks and then return to hospital for a pregnancy test.” Their wait was well worth it because the news was good.
Elaine and Tom were told they were expecting a baby. “I knew already,” laughed Elaine, “because I’d done a pregnancy test at home. “I was so happy. We felt so lucky. This tiny embryo was our baby and I was so grateful. I was so surprised because our chances were very slim.” Elaine took things easy over the next few months and made sure she looked after herself. But at week 32 of her pregnancy, doctors started to worry about the baby. A scan showed that he was not growing properly and medics were worried that Elaine’s placenta was not functioning properly.
On Christmas Eve, it was decided that Elaine should be induced at the City General. She said: “I was nervous, because the baby was only just 35 weeks, but I knew I had no choice. The baby needed to be born because it wasn’t getting what it needed from me.” On Christmas Day 2.30pm, baby Jacob was born by Caesarean section, weighing 4lbs 6ozs. “We missed our Christmas dinner,” laughed Tom. “But we had more important things to do. Our son was born and that was just amazing. “We felt very blessed. We never dreamed we’d ever have a baby. He was lovely.” Elaine and Jacob stayed in hospital together for a week. Elaine came home on New Year’s Day and Jacob moved to the neonatal unit. She said: “It was hard leaving him, but he needed extra care. He wasn’t feeding too well and the doctors needed to keep an eye on him. ”When Elaine brought him home, on January 6, she was the proudest mother alive. And since then, she has enjoyed every single moment with her precious son. Jacob is now 12 weeks old and weighs a healthy 10lbs 2oz. Life couldn’t be more perfect for us,” said Elaine. “I love being a mum –it’s the best thing. If someone had told me that by 2007, I’d be married with a baby son I’d have laughed and laughed – but it’s no joke.”
Dr Suhaimi Hassan, who performed both Elaine’s egg collection and embryo transfer at CARE Fertility, said: “We are absolutely delighted to have been able to assist Elaine and Tom in achieving their dream to become a family and wish baby Jacob and his parents every happiness.”
WENDY ROBERTS
THE EVENING TELEGRAPH
Tom and Elaine Musson met and married in just a few weeks but, though they found love swiftly, time was not on their side when it came to starting a family. In fact, Elaine, who was in her 40s, had given up hope, especially when fertility treatment hit problems. But miracles do happen, as Wendy Roberts discovered.
WHEN Tom and Elaine Musson swapped numbers in a crowded bar, they never envisaged planning their wedding nine weeks later.
But after a whirlwind romance, the pair set a date and exchanged marriage vows. Life was looking perfect for the couple. But it’s been even better since their baby son, Jacob Alexander Gabriel, was born on Christmas Day. “We weren’t looking for love and we’d certainly ruled out ever having children,” said 44-year-old Elaine. “Now we’re married and have a lovely baby boy. It’s absolutely amazing,” she smiled. “He came on Christmas Day. He was the greatest gift we could have received. “These last months have been wonderful for us and Jacob is the most beautiful, contented baby. He’s adorable.” Elaine and Tom Musson, 46, of Scaddows Cottage, Ticknall, still cannot believe how much their lives have changed in the last three years.
Just finding each other and falling in love, they say, is nothing short of a miracle. But they believe having Jacob is their biggest achievement – especially when you hear how they needed intricate fertility treatment to get him. “Our wedding day was very quiet,” said Elaine. “We invited eight of our friends to Burton Register Office, and enjoyed a simple ceremony. Afterwards, we went to a bar for champagne. It was lovely.” Elaine and Tom started to try for a baby but it wasn’t long before they realised something was wrong. “We tried getting pregnant for a few months, and then I started thinking about my ticking body clock,” said Elaine, a psychiatric nurse. “I went to see the doctor, who ran a few tests.” News that Elaine’s fallopian tubes were blocked came as a shock. Elaine underwent treatment to try to clear them.
She said: “At my age, we were told that we’d have to pay for any kind of fertility treatment, but we had savings.” But Elaine became pregnant straightaway – and naturally. “I was over the moon,” she said. “It was great news. I could hardly believe it.” Then disaster struck. At six Weeks pregnant, Elaine had a miscarriage. The couple decided to invest £6,000 in a course of fertility treatment with CARE Fertility in Nottingham. They were advised to have IVF, where an egg is combined with sperm in a laboratory dish. If the egg fertilises, the resulting embryo is transferred into the woman’s uterus. Usually more than one egg is fertilised to give couples a better chance of having a baby. ICIS (Intracytoplasmic Sperm Injection) was also recommended. This is a procedure in which a single sperm is injected directly into an egg.
The couple were given an appointment at Derby City General Hospital, where CARE has a satellite unit. Elaine said: “It was quite daunting, because it was all so new. I felt a bit stressed because I knew time was against me. I was 43 at the time.” Almost as soon as Elaine and Tom started their first course of treatment doctors decided to abandon it. Elaine was not responding to the course of drugs she was taking and there was no chance the treatment was going to be successful. “It was a slap in the face,” said Elaine. “I was disappointed, but I knew that the doctors were right in their decision.
“We agreed to try again the following month with a higher dose of medication.” Elaine quit her nursing job to concentrate on the treatment and Tom did as much as he could to support his wife. “It was very stressful when we discovered that only one egg was good enough to be fertilised,” she said. “Some women produce loads of great eggs, but we just had one.” Elaine admits that she thought the treatment would probably fail, but piled all her hopes on her one embryo. “The doctors said it was a very healthy embryo, but I shouldn’t get too excited,” she said. “I was told to rest for two weeks and then return to hospital for a pregnancy test.” Their wait was well worth it because the news was good.
Elaine and Tom were told they were expecting a baby. “I knew already,” laughed Elaine, “because I’d done a pregnancy test at home. “I was so happy. We felt so lucky. This tiny embryo was our baby and I was so grateful. I was so surprised because our chances were very slim.” Elaine took things easy over the next few months and made sure she looked after herself. But at week 32 of her pregnancy, doctors started to worry about the baby. A scan showed that he was not growing properly and medics were worried that Elaine’s placenta was not functioning properly.
On Christmas Eve, it was decided that Elaine should be induced at the City General. She said: “I was nervous, because the baby was only just 35 weeks, but I knew I had no choice. The baby needed to be born because it wasn’t getting what it needed from me.” On Christmas Day 2.30pm, baby Jacob was born by Caesarean section, weighing 4lbs 6ozs. “We missed our Christmas dinner,” laughed Tom. “But we had more important things to do. Our son was born and that was just amazing. “We felt very blessed. We never dreamed we’d ever have a baby. He was lovely.” Elaine and Jacob stayed in hospital together for a week. Elaine came home on New Year’s Day and Jacob moved to the neonatal unit. She said: “It was hard leaving him, but he needed extra care. He wasn’t feeding too well and the doctors needed to keep an eye on him. ”When Elaine brought him home, on January 6, she was the proudest mother alive. And since then, she has enjoyed every single moment with her precious son. Jacob is now 12 weeks old and weighs a healthy 10lbs 2oz. Life couldn’t be more perfect for us,” said Elaine. “I love being a mum –it’s the best thing. If someone had told me that by 2007, I’d be married with a baby son I’d have laughed and laughed – but it’s no joke.”
Dr Suhaimi Hassan, who performed both Elaine’s egg collection and embryo transfer at CARE Fertility, said: “We are absolutely delighted to have been able to assist Elaine and Tom in achieving their dream to become a family and wish baby Jacob and his parents every happiness.”
WENDY ROBERTS
THE EVENING TELEGRAPH
IT'S A MAN THING (or are men really from Mars???...)
Marsali McDonald PhD
Senior Clinical Counsellor
CARE Fertility
Nottingham, UK
''He doesn't talk to me!''
''I never know what he's feeling!''
''I just don't understand him!''
''Men! Can't live with them-can't live without them!''
It's well known that infertility and the stress of treatment can drive couples apart. Communication can break down, couple end up feeling unheard and misunderstood by their partner-and resentments can build up. They stop talking to each other and start bickering and in some cases seperating.
So what goes wrong? I suppose the nub of it is that men and women tend to deal differently with stress and emotional pain. Research into how men and women express feelings of grief clearly shows that they do that in very different ways. One is not better than the other: they are just different and once we recognise that it's easier to understand what is going on for the other person.
The loss of fertility, failed treatments, ectopic pregnancies, miscarriages and infant death are all pretty profound events that result in feelings of grief for both men and women. They just don't necessarily show it in the same way.
Generally speaking men have a problem solving approach to life. Got a problem? Find a solution. If there is no solution to the problem do not waste time worrying about it. Put your energy into something constructive, like going back to work or building a garage. Women on the other hand, tend to deal with problems by talking about them. It does not matter that talking about them is not going to solve them. The act of talking it through is helpful in itself. Men need to do. Women need to talk.
Ther is no solution to a failed treatment. She can't understand how, an hour after hearing that treatment has failed, he is out digging the foundations for a new patio. She interprets that as him not caring. She wants to talk about it. He knows that talking about it will not change the situation and he feels inadequate and frustrated. There is nothing he can do to solve the problem. So he goes out and digs deeper foundation. She doesn't want him him to find a solution. She just want him to sit and talk to her to share his feelings. When he dissapears out into the garden again she thinks it is because he doesn't really care. And so the merry dance goes on.
And the whole nature of fertility treatment can make it worse. Men the 'doers' have so little to do here. Once he has produced his sample he can feel redundant. It is the women who takes the drugs, has the blood tests, scans and nurtures the embryos. What can a bloke do other than sit around feeling like a bit of a spare part!If it is his 'problem' that can intensify his feelings of powerlessness. If he has a low sperm count or no sperm, if donor sperm is used, he has even less to do. He can feel humilated as well as redundant. Being infertile can dent the confidence of the most self assured of us. It hacks at the roots of our self esteem and sense of who we are. Fertility can still be confused with virility in some people's minds. So infertile men can feel acute shame, guilt and inadequacy. If it wasn't for him, his partner wouldn't have to go through the wretched treatment.
And all this to the fact that men generally do not talk about how they are feeling-and women need to talk about it-and you have a powerful cocktail of potential misunderstandings.
So the next time he goes into the garden shed to hammer nails into something, it's not that he doesn't care. It is just a man thing. And the next time she asks you to sit down and talk about it, she is not expecting you to magic up a solution. It is just a woman thing
Perhaps there is room for both these ways of dealing with our feelings and we can meet somewhere in the middle. And VIVE LA DIFFERENCE!!!!!
Senior Clinical Counsellor
CARE Fertility
Nottingham, UK
''He doesn't talk to me!''
''I never know what he's feeling!''
''I just don't understand him!''
''Men! Can't live with them-can't live without them!''
It's well known that infertility and the stress of treatment can drive couples apart. Communication can break down, couple end up feeling unheard and misunderstood by their partner-and resentments can build up. They stop talking to each other and start bickering and in some cases seperating.
So what goes wrong? I suppose the nub of it is that men and women tend to deal differently with stress and emotional pain. Research into how men and women express feelings of grief clearly shows that they do that in very different ways. One is not better than the other: they are just different and once we recognise that it's easier to understand what is going on for the other person.
The loss of fertility, failed treatments, ectopic pregnancies, miscarriages and infant death are all pretty profound events that result in feelings of grief for both men and women. They just don't necessarily show it in the same way.
Generally speaking men have a problem solving approach to life. Got a problem? Find a solution. If there is no solution to the problem do not waste time worrying about it. Put your energy into something constructive, like going back to work or building a garage. Women on the other hand, tend to deal with problems by talking about them. It does not matter that talking about them is not going to solve them. The act of talking it through is helpful in itself. Men need to do. Women need to talk.
Ther is no solution to a failed treatment. She can't understand how, an hour after hearing that treatment has failed, he is out digging the foundations for a new patio. She interprets that as him not caring. She wants to talk about it. He knows that talking about it will not change the situation and he feels inadequate and frustrated. There is nothing he can do to solve the problem. So he goes out and digs deeper foundation. She doesn't want him him to find a solution. She just want him to sit and talk to her to share his feelings. When he dissapears out into the garden again she thinks it is because he doesn't really care. And so the merry dance goes on.
And the whole nature of fertility treatment can make it worse. Men the 'doers' have so little to do here. Once he has produced his sample he can feel redundant. It is the women who takes the drugs, has the blood tests, scans and nurtures the embryos. What can a bloke do other than sit around feeling like a bit of a spare part!If it is his 'problem' that can intensify his feelings of powerlessness. If he has a low sperm count or no sperm, if donor sperm is used, he has even less to do. He can feel humilated as well as redundant. Being infertile can dent the confidence of the most self assured of us. It hacks at the roots of our self esteem and sense of who we are. Fertility can still be confused with virility in some people's minds. So infertile men can feel acute shame, guilt and inadequacy. If it wasn't for him, his partner wouldn't have to go through the wretched treatment.
And all this to the fact that men generally do not talk about how they are feeling-and women need to talk about it-and you have a powerful cocktail of potential misunderstandings.
So the next time he goes into the garden shed to hammer nails into something, it's not that he doesn't care. It is just a man thing. And the next time she asks you to sit down and talk about it, she is not expecting you to magic up a solution. It is just a woman thing
Perhaps there is room for both these ways of dealing with our feelings and we can meet somewhere in the middle. And VIVE LA DIFFERENCE!!!!!
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