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Evidence Challenges Effectiveness Of Embryo Screening For Older Women
There is growing evidence that a procedure for identifying chromosomal abnormalities in embryos prior to in vitro fertilization is ineffective at helping older women become pregnant, the Wall Street Journal reports. The procedure -- known as pre-implantation genetic screening, or PGS -- is performed in dozen of U.S. fertility clinics and sometimes marketed to older women as a way to increase the odds of a healthy live birth. PGS involves extracting a single cell from a six-cell embryo and inspecting it for chromosomal abnormalities known as aneuploidies; unaffected embryos can then be implanted through IVF. Women older than age 35 have a higher risk of aneuploidies, in which embryos have fewer or more than the usual number of 23 pairs of chromosomes. Aneuploidies can trigger early miscarriage or certain genetics conditions, such as Down syndrome. Most medical experts agree that embryo screening is capable of significantly reducing the risk of Down syndrome and other serious chromosome-related illnesses. However, evidence from several studies increasingly suggests that the procedure does not increase older women"s chances of healthy live births. The American Society for Reproductive Medicine released an initial opinion about PGS in 2007, saying that available evidence does not support the use of embryo screening to increase live birth rates in older women. Andrew La Barbera, scientific director of the society, said, "Since that time, there have been several more trials that have reached the same conclusion." Another shortcoming is that most clinics can only test for fewer than half of the 23 chromosomes, meaning that many defects can go undetected. However, medical experts say that the use of PGS has increased in the two years since ASRM issued its recommendations. According to the Journal, PGS can add more than $2,000 to the roughly $10,000 cost of one IVF cycle. Very few health insurers cover PGS, though some pay for IVF. Some experts contend that studies showing a lack of clinical benefit from PGS do not use more efficient biopsy techniques that can prevent damage to the embryo. Santiago Munne, scientific director for Reprogenetics, said that the treatment is "effective." In a 2007 study, Munne and colleagues used PGS to reduce the rate at which patients miscarried. However, the chances of a woman getting pregnant largely were unchanged, which the authors said could be attributed to the small number of study participants (Naik, Wall Street Journal, 6/1).
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AVMA Response To PETA Protest At The Association's Annual Convention
The American Veterinary Medical Association (AVMA) respects and values PETA"s right to express an opinion and hold a peaceful demonstration at our 146th Annual Convention in Seattle. On the other hand, we disagree with their position on our use of fish during an educational and motivational presentation by the fishmongers of Pike Place Fish Market.
News of the day
VaxInnate Reports Positive Results From Preclinical Testing Of Swine Flu Vaccine Developed Using Novel Technology
VaxInnate Corporation today reported positive preclinical results for a recombinant swine flu vaccine it developed in less than three weeks, making it one of the first companies in the world to begin testing a vaccine that could help halt the spread of the swine flu pandemic.
Cardiovascular

Number Of Uninsured California Kids May Double

A new deal to balance California"s budget may have serious repercussions for the health of the state"s children, while South Carolina grapples with health cuts of its own. Meanwhile, New Jersey may become one of the first states to publically disclose hospital errors. "California"s budget deal is expected to nearly double the state"s number of uninsured children and puts a spotlight on a key provision in the health-care bills in Congress," the Wall Street Journal reports. "Gov. Arnold Schwarzenegger this week signed a revised annual budget to close California"s $24 billion shortfall, including a $1.4 billion cut to Medi-Cal, the state"s version of Medicaid. In addition, California slashed $178.6 million from Healthy Families, its version of the Children"s Health Insurance Program. In all, California"s cuts could raise the number of uninsured children in the state to two million, up 915,000 from about 1.1 million in 2007, estimated the Children"s Defense Fund, an advocacy group that backs coverage for uninsured children. The UCLA Center for Health Policy Research, a nonpartisan research organization, called the estimates reasonable." California"s cuts "throw into question some aspects of the federal health-care bill now winding its way through Washington. The Senate bill calls for states to expand their health-care programs to more of the uninsured, even as the federal government would start scaling back funding for such state programs in 2015. California"s predicament suggests some states could only afford to expand coverage with 100% federal funding, said Gerald F. Kominski, associate director of the UCLA Center for Health Policy Research" (Knutson, 8/1). Monique Kolster and her two children, one of whom has a chronic illness, are waiting to find out "if the children can keep their medical coverage from California"s budget-ravaged Healthy Families program, the safety net for hundreds of thousands of children. Kolster and her husband don"t earn much money," the Sacramento Bee reports. "Their budget would be stretched thin if they had to turn to private insurance for Tadd and Elle. Yet the family isn"t poor enough for the children to qualify for Medi-Cal." In Sacramento and throughout California, "news of the Healthy Families cuts has brought more turmoil to families already struggling with an economic downturn, a looming school year with its demands for health exams and vaccinations, and a raft of difficult household budget decisions. Cuts in the program could be further deepened by a loss of federal matching funds, which provide two dollars for every state dollar spent on Healthy Families. In total, the program may lose more than $500 million" (Calvan, 8/3). In South Carolina, "The state agency that serves people with mental retardation and brain injuries might have sidestepped cuts to in-home care if state money and federal stimulus funding had been used differently, say legislators and agency officials," Greenville Online reports. "Instead, next year, hundreds of families will lose some of the in-home respite care, adult companions and other services that they say are vital to helping them maintain jobs while keeping disabled relatives out of institutions. Top officials at the state Department of Disabilities and Special Needs said massive budget cuts made the reductions unavoidable - but that it would have been possible to maintain services if the Legislature had allowed the agency to keep more of the $40 million in federal stimulus it qualified for" (Szobody, 8/3). Meanwhile, "New Jersey is poised to become one of the few states that will publicly disclose preventable medical errors on a hospital-by-hospital basis," Congress Daily reports. "The Legislature passed the measure in June and Democratic Gov. Jon Corzine is expected to sign it. The state"s Department of Health and Senior Services would be required to report information on 14 pre-established patient safety indicators, such as a foreign body left after a medical procedure or surgery performed on the wrong side. Under current law, hospitals voluntarily collect information about errors and report them to the state. Those figures are disclosed in the aggregate but they do not show specific hospital events" (Jordan, 8/3). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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