Category Archives: Embryology

Embryology

Fertility clinics asked to suspend treatment due to coronavirus – BioNews

23 March 2020

New guidance has called for fertility clinics in the UK to minimise treatment amid the coronavirus pandemic.

UK fertility clinics have been asked to consider, but not ordered, halting fertility treatment services. While it will not be possible for most clinics to close completely due to their legal responsibility to maintain stored frozen embryosand gametes, they are asked to reduce their services to a minimum.

The guidance, issued on Wednesday by the British Fertility Society (BFS) and the Association of Reproductive and Clinical Scientists (ARCS), states that 'it is expected that UK licensed fertility centres will now be working to suspend treatments'.

This includes IVF, frozen embryo transfer, surgical sperm retrieval, intrauterine insemination (IUI) and ovulation induction procedures. The guidance is in line with recommendations from the European Society of Human Reproduction and Embryology (ESHRE), who have advised all those considering fertility treatment to 'avoid becoming pregnant at this time'.

The news comes after Belfast's Regional Fertility Centrepostponed fertility treatment for 33 patients last week following advice from the Belfast Health Trust (see BioNews1039).

The BFS and ARCS cited the promotion of social distancing and lack of long-term evidence on the novel coronavirus (SARS-CoV-2) and pregnancy as the rationale underlying their recommendations. They also urged fertility clinics to consider their 'wider social responsibility' to an already stretched NHS, as fertility treatment may cause complications in some patients.

The new measures have caused uncertainty for many undergoing or considering fertility treatment, with no indication of when the restrictions will be lifted. Speaking to the Huffington Post, Tracey Bambrough, co-founder of the magazine IVF Babble, said: 'For people who may already be experiencing a rollercoaster of emotions, the coronavirus has created an additional level of anxiety.'

Another patient told the Telegraph: 'I worry my time is running out. I may not get many other chances to do this.' After trying to conceive for two years, she was awaiting IUI treatment when her clinic cancelled all procedures due to the coronavirus a situation in which many patients may now find themselves.

She added: 'I had some hope we might finally have a chance. It felt like we were on the road to something. Now, everything hangs in the balance.'

Some say the measures discriminate against those who need fertility treatment to get pregnant. Speaking to the Huffington Post, one patient said:'Everyone keeps joking that there's going to be a baby boom in nine months [from couples self-isolating together] is there going to be a public health announcement to stop fertile couples from sleeping together?'

The Human Fertilisation and Embryology Authority (HFEA) have asked that clinics follow the guidance and are providing regular updates on their website.

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Fertility clinics asked to suspend treatment due to coronavirus - BioNews

Embryology

Its really upsetting when you have put your body through so much: how it feels to undergo IVF through coronavirus – Stylist Magazine

Stylist spoke three women who had been affected by the situation and explored why there is not clearer guidance from the UKs regulatory body, the Human Fertilisation and Embryology Authority (HFEA).

Caroline, 32, from Manchester, was told her cycle was cancelled three weeks into a gruelling routine of daily injections. I was three weeks in to my fourth IVF cycle so thats three weeks of injections and menopausal symptoms. I was due to have a scan yesterday to confirm that I can start my next lot if medication ready for transfer in just over two weeks.

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Its really upsetting when you have put your body through so much: how it feels to undergo IVF through coronavirus - Stylist Magazine

Embryology

Coronavirus pandemic spurs halt to fertility treatments – The Globe and Mail

Ash Mogg, 36, who has had IVF cancelled due to COVID-19, outside her home in Toronto on March 20, 2020.

Tijana Martin/The Globe and Mail

Ash Mogg and her partner waited nearly a year on a list for provincially funded IVF in Ontario. Ms. Mogg, who is 36 and has a low egg reserve, was finally about to start the process in two weeks, but on Wednesday a nurse phoned with heartbreaking news. With all the uncertainty around COVID-19, the Toronto hospital was cancelling infertility treatments indefinitely.

I cried for five hours," Ms. Mogg said. "This whole situation, with COVID, in some ways it has the same feeling as infertility. Everything is so uncertain theres nothing to hold onto.

In the past few days, fertility clinics across Canada have been informing patients that new treatment cycles are being put on hold. They made the move after the Canadian Fertility and Andrology Society, which is not a regulatory body but provides guidance to the industry, issued a recommendation on Wednesday to postpone new insemination, in vitro fertilization and frozen embryo transfers until further notice, citing concerns about health-care resources. (The only exception would be for urgent cases involving cancer patients.)

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Read also: IVF was my last hope to have a baby. All Canadians deserve that hope, too

The American Society for Reproductive Medicine released a similar advisory. And in Europe, the European Society of Human Reproduction and Embryology has cautioned that all fertility patients considering or planning treatment should avoid becoming pregnant at this time, citing the lack of information around how the novel coronavirus that causes COVID-19 affects early pregnancy.

For all the jokes about a forthcoming COVID-19 baby boom as couples around the world isolate in their homes some health professionals are raising red flags about whether its wise to get pregnant amid the outbreak. This alarming warning is driven by concerns about the strain on an already stretched health-care system, a lack of data around how the virus affects the first and second trimesters, and unease about whether hospitals will have the capacity to provide proper care for pregnant women and newborns.

For people like Ms. Mogg, the idea of having to press pause on starting a family is yet another devastating layer to this crisis.

When everything started shutting down, I kind of suspected something like this was going to happen, but it was still a blow, she said. Timing is obviously critical for me.

Fiona Mattatall, a Calgary-based obstetrician and gynecologist, said given all of the uncertainty around COVID-19, she would suggest families consider delaying attempts at getting pregnant until more is known.

This is only a virus weve known about for months, not years, Dr. Mattatall said. When it comes to the first-trimester exposure, it is a giant question mark.

One good bit of news is that an analysis of amniotic fluid and cord blood from nine infected woman who delivered at Zhongnan Hospital of Wuhan University in China this year didnt detect the virus.

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This is hopeful, early information that babies may be protected it the womb, Dr. Mattatall said, adding its still too early to say for certain. (Researchers also determined the virus was not present in breast milk.)

As for the risk to mothers, reports from China suggest that the majority of pregnant woman with confirmed cases suffered just mild to moderate symptoms, and babies born to infected mothers have also done well.

Vanessa Poliquin, co-chair of the infectious disease committee of the Society of Obstetricians and Gynaecologists of Canada, said the absence of information isnt necessarily a bad thing. The virus has been spreading around the world for months now. Its conceivable, said Dr. Poliquin, that women are being infected while pregnant in their first trimester.

And we havent heard of a spike in miscarriages and we havent heard of a spike in rates of abnormalities being seen on anatomy scans, she said. This was not the case with the Zika virus, she said, where health providers saw problems and sounded the alarm.

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So far SOGC has not issued any warnings about delaying pregnancy, but the agencys chief executive officer, Jennifer Blake, said it may be worth considering.

The big unknown is how the pandemic will affect our health-care system and the ability to give routine pregnancy care. For example, will you be able to get an ultrasound when and where you might normally expect, she said. If its an option you may want to wait. If thats not an option, we will make sure you get the care you need.

Tom Hannam, founder of Hannam Fertility in Toronto, said part of the problem is no one knows how long the outbreak will last.

Were looking at something that could be three months or seven months or a year and a half. None of us knows, he said. Whats it going to be like going to a hospital nine months from now? Is it going to be a healthy and safe birth experience?

Some clues can be gleaned from other cities.

Edith Cheng, chief of maternal-fetal medicine at University of Washington hospital in Seattle, one of the early North American epicentres for the outbreak, said theyre currently trying to sort through complicated logistics.

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At present, the hospitals policy is that patients who are positive for COVID-19 cannot have guests. So an infected woman in labour would need to be alone.

Just 12 hours ago [our] pediatric leaders said we are now going to have to recommend, for sure, that [positive] moms and babies are separated because of some limited and new data that reports that babies less than a year old are potentially at higher risk, Dr. Cheng said.

Mothers are able to refuse this recommendation, but what happens at that point is still under discussion.

The complications around infected mothers means it takes more staff resources to handle safely. A delivery earlier this week required 13 staffers.

London is another city thats experiencing a crush of new COVID-19 cases. Last week, we had no cases at my hospital, said Rosemary Townsend, who works at a hospital in the citys south end. This week we have over 30 confirmed.

Hours earlier, her unit delivered its first baby to a mother suspected of being COVID-19 positive. (The confirmation test is pending.)

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In that case, the woman knew she was symptomatic and called in advance. An official met her and her partner in the parking lot and put masks on them. Usually women are moved to different parts of the maternity ward before and after delivery, but in this case the patient was in an isolated area.

Asked if she thinks families should postpone plans to try and get pregnant, Dr. Townsend said she just had this conversation with a friend who happens to work in health care.

Shes 38. She decided that she doesnt want to wait. The risk of waiting and delaying pregnancy is greater than the risk of getting pregnant in the middle of whats going on, Dr. Townsend said.

Sign up for the Coronavirus Update newsletter to read the days essential coronavirus news, features and explainers written by Globe reporters.

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Coronavirus pandemic spurs halt to fertility treatments - The Globe and Mail

Embryology

Guidance for the care of fertility patients during the coronavirus COVID-19 pandemic – BioNews

20 March 2020

The British Fertility Society (BFS) and the Association of Reproductive Clinical Scientists (ARCS) have announced new guidelines for fertility patients during the coronavirus pandemic.

Summary

UK COVID-19 epidemic continues to escalate.

Whilst pregnant women can be generally reassured they are asked to consider themselves a vulnerable group.

It is expected that UK licenced fertility centres will now be working to suspend treatments.

UK fertility centres must establish the requirements to maintain a minimum service, which may include non-elective fertility preservation.

Centres are expected to keep communication open with patients for advice and reassurance.

Centres are expected to minimise their impact on National Health Service (NHS) resources.

Background

A novel coronavirus infection that can cause serious disease (COVID-19) in a minority of affected people has taken on pandemic proportions, leading to extraordinary measures being introduced across the world.

The situation with respect to the number of affected persons and UK government advice on measures to increase social distancing is evolving. As of 18 March 2020: 56,221 people have been tested in the UK of whom 2662 tested positive for coronavirus, and 104 have died as a result of the illness. The government has advised against non-essential social contact and non-essential travel. Self-isolation has been advised for anyone with symptoms of coronavirus along with their household. The NHS has imposed restrictions on elective surgical and outpatient work, other than in situations where this is needed for the treatment of cancer or the purpose of saving life. The NHS has put in place plans for using medical and nursing staff from different areas in the most efficient way to deal with anticipated patients. This includes block-buying capacity in private hospitals. The aims of these measures are to free-up the maximum possible inpatient and critical care capacity, to prepare for anticipated large numbers of COVID-19 patients who will need respiratory support and to support staff and maximise their availability.

This guidance builds on the initial response from BFS and ARCS to this unprecedented challenge to the UK health system and the health of the population. It is designed to help all UK fertility clinics, regardless of their setting, to prioritise and organise their activities during the outbreak, whilst complying with their clinical, ethical, regulatory and social duties. Few UK licenced clinics will be able to close down completely, since virtually all will have embryos and gametes in storage banks which must be properly maintained in accordance with the law. Centres are advised to plan a flexible local policy which allows for prioritisation and a number of eventualities. Policies must take into account local conditions, breadth of work undertaken and clinic resources (including financial resilience). The overriding priority is for centres to act in a socially responsible manner.

Policies to take into account include the national strategy led by the chief scientific advisor and chief medical officer. Hospital-based clinics will be influenced by their own trust pandemic strategy which is likely to mirror national plans. Clinic groups may develop an overarching strategy, whilst individual centres will need to consider local prevailing conditions.

In developing their local policies, clinics must take into account their duty to abide by regulations arising from the Human Fertilisation and Embryology Act 2008, and laid out by the Human Fertilisation and Embryology Authority (HFEA) in its Code of Practice. HFEA guidance to clinics is available and updated as required. In all this, clinicians retain an ethical responsibility of beneficence and non-maleficence to their patients. A wider social responsibility of promoting public health and preventing harm from infection exists for all citizens, but especially health care providers. All clinics, whether in the state or private sector, should be mindful of their wider responsibilities, including the need to promote social distancing and to consider the potential effects of their work on local NHS services, which are likely to be stretched to an unprecedented extent.

At the time of writing, it is not thought that the infection causes miscarriage or fetal abnormality, and pregnant women do not appear to be at increased susceptibility to the infection or to developing complications. However, in the Prime Minister's bulletin on 16 March 2020, it was made clear that pregnant women were considered a vulnerable group, because this is a new infection and data on effects in pregnancy is limited. Further, there is concern for the potential care commitment required for any pregnant women with symptoms. The question arises whether the benefit of continuing to treat our infertile population may be outweighed by the additional concerns. It is reasonable that women who have risk factors for severe illness if infected, for instance those with diabetes or underlying respiratory disease or immunosuppression, should be advised against conceiving during the outbreak.

Fertility patients with symptoms of COVID 19

Pregnancy should be avoided in women who display symptoms of COVID-19. Patients who are in the stimulation phase of their treatment, but have not yet received the trigger, should be advised treatment cancellation. In such a situation, stopping follicle stimulating hormone (FSH) while continuing with gonadotropin-releasing hormone (GnRH) antagonist (or agonist as the case may be) is likely to protect against ovarian hyperstimulation syndrome (OHSS). Patients should be counselled against unprotected intercourse to avoid the risk of multiple pregnancy.

Patients who have received human chorionic gonadotropin (hCG) or GnRH agonist trigger may proceed to egg collection and freeze-all, if appropriate facilities are available and after a multi-disciplinary assessment of risk.

Patients who develop symptoms after oocyte collection should not have an embryo transfer.

Embryo transfer, or intra-uterine insemination should not be carried out in women with suspected or diagnosed COVID-19.

Stopping treatment programmes

For the reasons above, it is expected that, as the UK epidemic is now proceeding, all centres will stop initiating new fertility treatments, including in vitro fertilisation (IVF), frozen embryo transfer, surgical sperm retrieval, insemination and ovulation induction. This is also in keeping with recommendations from other professional bodies in the field of fertility treatment (Ref 4 and 5). When such a decision is made, it is reasonable for clinics to complete treatment that has already commenced in patients who remain well and where the centre's resources allow this to be done safely. However, clinics should be mindful both of their duty to minimise spread and of the impact of any complications on the NHS. Moderate or severe OHSS, which is often managed in an NHS emergency care setting, has been reported in 3.1 to 8 percent of stimulated treatment cycles. The risk of OHSS is reduced by the use of GnRH agonist trigger and freeze-all. It is mandatory therefore to consider these measures in women currently in the process of treatment.

Fertility preservation

Where resources allow, it is appropriate to continue non-elective fertility preservation, for example sperm and oocyte or embryo storage for cancer patients, provided they show no symptoms of infection. It should be borne in mind that these patients may be immunocompromised, and shared decision-making involving the patient, oncologist and fertility specialist is key. Fertility preservation should only be carried out in patients who remain well during treatment, and provided sufficient resources are available to do this safely. Local arrangements will be needed to allow these procedures to take place.

Outpatient clinics and diagnostic work

As part of social distancing, it is reasonable to advise that all face-to-face work should pause, other than in emergency situations, and where delay would be detrimental to the prospects of patients. Where possible, clinics should facilitate telephone or video consultations. If patients are attending for face-to-face encounters, care should be taken to stagger appointment times to prevent large groups of people congregating in waiting areas. Group sessions and support group meetings should not go ahead while social distancing is in place. Staff who can work from home should be facilitated to do so where appropriate, by provision of remote access to electronic case records as confidentiality restrictions allow.

Patient support and communication

Clinics should be aware of the potential emotional impact of the disruption of treatment services on their patients, occurring on a backdrop of anxiety about the effects of the virus itself. Measures should be put in place to keep patients informed of changes to the service and the reasons for these. Patients are likely to have concerns about the effect of delay on their chances of success and eligibility for NHS funding. It is likely that the ongoing uncertainty about the length of delay will compound these worries. All members of the clinical team have a role to play in supporting patients, with a special emphasis on the role of trained counsellors. It is recommended that usual facilities for answering phone call queries be enhanced to account for increased demand around short notice changes in service provision. Clinic websites and apps have a role in keeping patients informed and allaying anxieties in a difficult time.

Issues concerning funding and eligibility

Clinics should establish liaison with commissioners of NHS services to clarify their position on funding of treatment cycles that are cancelled, and the eligibility of patients who reach age thresholds without receiving treatment, due to the coronavirus outbreak. Significant numbers are likely to be affected, and it is likely that individual Exceptional Funding requests will not be appropriate for the circumstances we recommend that commissioners make timely decisions to guarantee treatment in the future for all currently eligible fertility patients negatively affected by the COVID-19 pandemic, to minimise distress and facilitate pathways once treatment resumes.

Staffing

Centres should work to identify the minimum number of staff that are necessary to maintain urgent services such as fertility preservation for oncology patients. It is likely in NHS settings that a large proportion of medical and nursing staff will need to be redeployed to other areas, however measures should be taken to try to ensure that staff with the requisite skills and training to deliver urgent treatments are available at all times. If sufficient staff are not available due to illness, then centres should seek support through their reciprocal support agreements with other centres or networks.

Sufficient scientific staff should be in place to maintain and ensure the ongoing safety of gamete and embryo storage banks. To guard against the risk posed by significant numbers of scientific staff becoming ill and forced to self-isolate, centres should ensure that sufficient scientific staff are available and are cross-trained to deliver all key tasks including ongoing quality control and maintenance.

Appropriate levels of staffing should be determined by the person responsible, taking advice from nursing, medical and scientific professional leads within the centre. It is incumbent upon public relations (PR) to ensure that services are reduced in keeping with available levels.

Diagnostic services

Where assisted conception centres undertake diagnostic activities, such as semen analysis or post-vasectomy testing and these involve attendance at the clinic, these should be suspended in order to minimise social contact.

Where diagnostic services are part of NHS pathology (or other) departments, the above also applies and staff may be asked to redeploy during the epidemic.

Resuming services

Whilst every effort must be made to reduce services over coming weeks and months, it is necessary to think forwards towards a resumption of services. Maintaining contact with patients whose treatment has been disrupted or deferred is important, and consideration should be given to prioritisation when services are able to recommence. The timing of this will be dependent on ongoing Government advice, resumption of NHS normal working practices as well as centres' own staffing and other resources.

The BFS and ARCS continue to monitor the ongoing pandemic and advice from national authorities. Further guidance will follow as appropriate, with the ultimate aim of resuming normal services as soon as possible.

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Guidance for the care of fertility patients during the coronavirus COVID-19 pandemic - BioNews

Embryology

Inquisitive Professors: Decades of Teaching and Learning – The Hilltop News

Alexis Westrick

There are many aspects of LaGrange College that appeal to potential students. There are dozens of great organizations and clubs, diverse majors to choose from, and a strong sense of community. But what really makes LaGrange special is the staff and professors who have dedicated their time and effort to help their students achieve their goals.

Recently, Dr. William Paschal, Dr. John Cook, and Dr. William Yin have all celebrated 25 years with the college, and Dr. Nina Dulin- Mallory has just celebrated 35 years. Susan Laforet, the secretary for the Science and Mathematics departments, has also been at LaGrange College for 25 years. Although she could not be contacted for this interview, her time and dedication to LaGrange is deeply appreciated.

Dr. Cook is a professor of religion and philosophy. He has taught Scriptures, American Christianity, Political Philosophy, and many other classes during his time at LaGrange. When asked if he preferred religion or philosophy, he said that he liked both, but it was refreshing to teach philosophy, because it involves more reason. He actually audited a physics class at the college and has taught a class on the philosophy of physics. Some people would not be able to find the connection, but he claims that you can see the hand of God in these theories.

Dr. Paschal describes Human Anatomy as his bread and butter, but his PhD is in Neurobiology. He also teaches a Paleoanthropology course and Vertebrate Embryology. Dr. Paschal teaches students from an assortment of majors including Biology, Nursing, and Exercise Science. Its a diverse lot, he says. Its a lot of fun to teach people I wouldnt normally meet.

Dr. Yin has the privilege of mentoring all of the math majors on campus, because while Analysis is his expertise, he also teaches classes like Probability, Calculus, and Problem Solving. He says that he really enjoys Problem Solving, because he gets to meet students from all areas of study. He explained that each major has a different perspective and a different way to tackle a problem.

Dr. Dulin-Mallory has been LaGrange Colleges Medieval expert for 35 years now, and, as she says with a laugh, everything else gets too complicated. Her favorite class to teach is Chaucer, because she was influenced by people who were enthusiastic when she was a student. She said, The energy and warmth with which they taught influenced how I feel about the subject. Anyone who has been in one of her classes knows exactly what that energy feels like.

LaGrange College has many gifted professors, and while they could have pursued careers at larger institutions, these four professors have remained dedicated to this institution and its students for decades. When asked why he chose to stay at LaGrange for over two decades, Dr. Cook immediately said, When I see a student come alive in class, start participating and asking questions. When a student with a lot of personal problems is able to turn that around and come out at the very top of the course. Its nice to see transformation like that. Its something that the college does well.

The Delta Tau Delta fraternity recently celebrated their 50th anniversary at LC. Dr. Paschal has served as the faculty advisor for the Delts for 25 years, so the 50th celebration was the perfect place catch up with alumni that he has known since their freshman year. When I knew them, they were kids, he explained. The greatest teaching moment is not something that you get all the time. Its not tangible. Its not something that you can measure. Its when you run into a student years later. I know I only played a small part in their time here, but I still feel like a proud papa when I see them all grown up. He went on to say that LaGrange Colleges small size is what makes it special. It allows students and faculty to build relationships, rather than limiting them to large lecture halls filled with a sea of 200 students.

Dr. Dulin-Mallory agreed, saying, The best connections take place, not in great halls, but in small spaces. The things that we take away happen in a conference, not in a room with a projector. She went on to say that she takes great pleasure out of the kind of students that come to LaGrange College, because they are curious and want to ask questions. Dr. Dulin-Mallory raised her family in LaGrange, and for thirty years she has lived across the street from the college.

Dr. Yin chose to stay at LaGrange College because of the interactions he has with the students. He mentioned one student in particular who went on to get his PhD from the University of Florida, and now that student runs his own company. Years later, Dr. Yin ran into this student and his girlfriend. As Dr. Yin and the student conversed about his former classmates, his girlfriend looked on in awe. Do you know all of your students? she asked. And Dr. Yin simply shrugged and said, Yeah. It is easy to forget how many students at larger institutions miss out on the opportunity to build personal relationships with their professors. At LaGrange College, the professors get to know their students, and they care about those students success.

Teachers at LaGrange College also get the opportunity to explore areas outside of their expertise. Many of them take full advantage of this fact, and they encourage their students to do the same. Dr. Cook explored a humanities class that was out of his area, where he was able to read The Odyessy and Platos Republic. He also taught a Jan-Term class about the writings of C.S. Lewis. He has held onto a phrase that LaGranges Reference Librarian, Dr. Arthur Robinson once said: Take a class in basket weaving. Dr. Cook explained, Take something completely out of your area just so you can have fun doing it. Life is going to be all work, and your job isnt going to be just your major, so finding other interests is important.

Dr. Yin agreed, saying, You have to think outside of the box of your own major. Problem Solving, if anything, is preparing students for life, because life will not always be within your major. Dr. Yin has taught a Bruce Lees Philosophy class with a former theater professor over Jan-Term where they discussed the acting and cinematic techniques behind Bruce Lees movies. Dr. Yin actually taught martial arts!

Anyone who is currently taking Shakespeare with Dr. Dulin-Mallory and Professor Barber Knoll this spring can tell that this duo has a blast teaching together. Dr. Dulin-Mallory teaches the evolution of the English language, while Professor Knoll explores the theater aspect of the study. Even though they are there to teach the students, they can also learn from each other. This is just gravy to do this with her, Dr. Dulin- Mallory says with a grin. We do thing like this out of joy and for the fun of it. Its an opportunity really, because its not particularly easy.

This past Jan-Term Dr. Dulin- Mallory explored another subject. She went to Iceland with a physicist from LaGrange College, where they saw the Northern Lights. She said it was great fun and that she learned a little about the science of that, but certainly not physics.

Dr. Paschal might be one of the professors that has ventured the furthest from his area of study. The crowded bookshelves in his office are not limited to paleontology and human evolution. They also host books about 19th century art, cave paintings, and Mayan ruins. There are even several Stephen King books in one corner. Ive always loved art, he explained, referencing the art book his parents kept on the coffee table. This book now lives on his bookshelf. I doodle and draw in class a lot. Not that theyre any good, he said, doubling over with laughter.

For his Jan- Term trip this past January, Dr. Paschal went to France with Dr. Joiner, LaGrange Colleges resident art historian. Together, they took students to famous Parisian museums such as the Louvre and the Muse dOrsay. They also explored the caves at Font de Gaume and Lascaux II and toured the French countryside. When he saw the cave paintings, Dr. Paschal expressed the endearing excitement and wonder of a child. Dr. Paschal has also been to Central America three times with the schools history department, where he was able to see the Mayan ruins, go bird watching, and see monkeys. There, he said, he learned about the emergence of our species and language.

Dr. Paschal encourages his students to also find joy in curiosity and exploration. He said, I think that a lot of students take a course, and if they dont see how it will help them in their chosen career, they think its not important. But theyre missing so much! Students need to open themselves up to new experiences. Find a way to enjoy it. Youll do a lot better in the course if youre curious, more active, and if you ask questions.

During their time here, these professors have seen students and colleagues come and go. Dr. Dulin- Mallory joked that her greatest accomplishment has been lasting. But she also says that being able to watch how things have changed has been a privilege. From pen and paper to computers and email, she has seen an arc of development. Perhaps it is her curiosity, and the curiosity of her colleagues, that has made the last couple of decades at LaGrange College so enjoyable. Many people think that there is no excitement in staying in one place, but they are not looking at it in the right way. These professors spend every day not only trying to spark their students interest, but also their own. They are teachers, but they also learn from their students and continue to grow along with them. And that is what makes it exciting. Dr. Dulin-Mallory had the answer to lasting when she said, Be curious. And never give up.

Alexis Westrick iscurrently a junior at Lagrange College. She is earning her undergraduate degree in English. She is also earning her BFA with a concentration in painting and drawing and graphic design.

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Inquisitive Professors: Decades of Teaching and Learning - The Hilltop News

Embryology

Connecting with NC Cooperative Extension – Asheboro Courier Tribune

What is NC Cooperative Extension?

We are more than cows and corn.

NC Cooperative Extension is Randolphs Countys link to the two land-grant universities in North Carolina (NC State and NC A&T). Land-grant universities have three parts to their mission: education, research and extension. NC Cooperative Extension extends research-based knowledge to all North Carolinians, helping them transform science into everyday solutions that improve their lives and grow our state.

Why Cooperative Extension?

Essential to extensions mission to grow the state is our collaboration with the US Department of Agricultures National Institute of Food and Agriculture (USDA-NIFA), NC State University, NC A&T State University and local (county) governments across the state. This strategic partnership and cooperation are why it is called Cooperative Extension.

Statewide, our funding is 14% federal, 36% state, 25% county and 25% other (grants, contracts donations etc). It is truly a cooperative effort to offer our services to North Carolina residents.

History of success: Then and now

In 1909, information was shared through a Boys Corn Club (the beginnings of 4-H) in Ashokie, NC, that adding nutrients to your cornfield by spreading manure could increase the corn yield. A young boy took that information when the average yield was 18 bushels per acre and increased his yield to 196 bushels per acre in two years. NC Cooperative Extension is still researching ways to increase farm productivity as the worlds population increases and with its demand for food.

Currently, agriculture is North Carolinas largest industry, generating $91.8 billion annually while employing roughly 17 percent of the states workforce. Ours is the third most diverse agriculture economy in the country, with more than 80 commercial crops and a large animal agriculture presence.

Another example from the early 1900s happened through Girls Canning Clubs. Young girls were taught food preservation. These girls sold their canned food in the wintertime to earn money. NC Cooperative Extension is still teaching life skills that build capacity in people. n 2019, 47,041 North Carolina consumers increased their knowledge of safe home food handling, preservation or preparation practices.

The Randolph County Center is fully staffed and offers services in all the NC Cooperative Extension program areas.

Adam Lawing is the Livestock Agent. Did you know that Randolph County has more beef cows and goats than any other county in North Carolina? Adam is a great resource for our Randolph County producers.

Blake Szilvay is the Field Crops/Forestry Agent. Blake helps producers identify pests and diseases in crops. He is a licensed drone pilot and uses that technology to help farmers. Blake has also brought forestry programming back to Randolph County to help woodland owners improve management practices. Over 50% of Randolph County is forested, and in 2016, those forested acres provided $4.6 million through harvests.

Ben Grandon is the Horticulture Agent. In 2019, Ben conducted 226 on-site consultations with homeowners. He helps with gardening questions, landscaping and lawn issues, and many more. Ben also leads the Randolph County Master Gardener Volunteer educational group. After Bens training, a Master Gardener Volunteer can provide research-based information about gardening and environmental stewardship to individuals. This years Master Gardener Training Course begins in April.

Jeannie Leonard is the Family and Consumer Sciences Agent. Jeannie can teach food preservation and cooking skills. Recently, her Cooking Under Pressure (Instant Pot) classes have been popular. Her next class is on March 26. Jeannie also works with Randolph County businesses and organizations when they want to offer their employees wellness programs. Jeannie provides training on healthy recipes and cooking tips on location or here at the office.

Allison Walker is the 4-H Agent. Allison is passionate about Randolph County youth. Currently, she is working with 60+ classrooms on the Embryology Project. Allison provides 1 dozen eggs and incubators to each classroom so the teachers can teach the provided embryology curriculum. The second graders learn firsthand about chick development and get to see the chicks emerge from their shells. 4-H is a great youth development program open to all youth, not just farm kids.

Jody Terry is the 4-H Program Assistant. Jody spends many days in afterschool programming. She helps children through character education, healthy lifestyle choices or STEM education. She is gearing up for Bike Safety Week where she helps teach bike safety to the fourth graders. Jody has worked with thousands of children in Randolph County through the years and still remains committed and passionate about 4-H programming for the children.

Contact us by calling 336-318-6000 or visiting https://randolph.ces.ncsu.edu/

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Connecting with NC Cooperative Extension - Asheboro Courier Tribune

Embryology

Merck Foundation launches programmes in partnership with Namibia First Lady and ministries of health and education – Namibia Economist

Merck Foundation recently announced the First Lady of Namibia as Ambassador of Merck more than a Mother; Merck Foundation Calls for Applications in Namibia for Merck More than a Mother Media Recognition Awards 2020 for English speaking countries to break infertility stigma; Merck Foundation also Calls for Applications for Merck More Than a Mother Fashion Awards from Namibia and rest of Africa.

Merck Foundation, the philanthropic arm of Merck KGaA Germany launched their programmes and conducted their first Merck Foundation Health Media Training in Windhoek, Namibia in partnership with H.E. Monica Geingos, The First Lady of Namibia and the Ambassador of Merck More Than a Mother together with Ministry of Health and Ministry of Education to break the stigma around infertility and build healthcare capacity in Namibia and rest of Africa.

Talking about the Health Media Training program Dr. Rasha Kelej, CEO of Merck Foundation and President of Merck More Than a Mother explained, The Health Media Training program is a part of Merck More than a Mother community awareness Program and is organized for the first time in Namibia for local media representatives and media students to emphasize their critical role to create a culture shift and to be the voice of the voiceless in order to break the stigma around infertile women.

Geingos emphasized, I am very excited to be appointed as ambassador of Merck more than a Mother and to officially launch Merck Foundation programs in our country. Moreover, I am very happy to host this important training program. Media plays an important role is sensitizing our society. It can help in creating awareness about female & male infertility and in breaking the stigma around infertility.

It is important to initiate this important training program as I strongly believe that media has the capacity and ability to break the silence in our communities in a regular and effective basis. Dr. Rasha Kelej added.

The training was addressed by Fertility specialists who are Merck Foundation Alumni and stalwarts of Media.

It provided a great opportunity for the journalists to listen to childless women experience with infertility stigma and to meet the experts and also to network with each other and work as a unit to eradicate the stigma around infertility and its resulted domestic violence in Namibia and rest of Africa.

Merck Foundation together with Namibias First Lady acknowledged the graduates of Merck Foundation programs in different fields of Oncology, Fertility and Embryology, Diabetes and Hypertension. and welcomed to be Merck Foundation Alumni for Namibia.

Merck Foundation in partnership with Ministry of Health of Namibia has provided training for doctors from Namibia to be the first oncologist and fertility specialists in public sector in the country. Moreover, they provided one year on line diploma in cardiovascular preventive medicines and masters program in diabetes management for two doctors. Merck Foundation has committed to continue providing these specialty training to more doctors from different provinces in Namibia.

Merck Foundation recently announced the winners of Merck More Than a Mother Media Recognition Awards 2019. They also announced for Namibian Media, the Call for Application of Merck More Than a Mother Media Recognition Awards 2020 for English speaking countries. The aim of these awards is to emphasize the role of media in enhancing the public engagement and understanding of infertility stigma and the need to change its social perception in African communities.

The applications are invited by media professionals to showcase along the year their work to raise awareness about infertility prevention and breaking infertility stigma.

Read the rest here:
Merck Foundation launches programmes in partnership with Namibia First Lady and ministries of health and education - Namibia Economist

Embryology

Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles. – DocWire News

This article was originally published here

Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles.

BMJ Open. 2020 Mar 16;10(3):e034566

Authors: Bahadur G, Homburg R, Bosmans JE, Huirne JAF, Hinstridge P, Jayaprakasan K, Racich P, Alam R, Karapanos I, Illahibuccus A, Al-Habib A, Jauniaux E

AbstractOBJECTIVE: To compare success rates, associated risks and cost-effectiveness between intrauterine insemination (IUI) and in vitro fertilisation (IVF).DESIGN: Retrospective observational study.SETTING: The UK from 2012 to 2016.PARTICIPANTS: Data from Human Fertilisation and Embryology Authoritys freedom of information request for 2012-2016 for IVF/ICSI (intracytoplasmic sperm injection)and IUI as practiced in 319 105 IVF/ICSI and 30 669 IUI cycles. Direct-cost calculations for maternal and neonatal expenditure per live birth (LB) was constructed using the cost of multiple birth model, with inflation-adjusted Bank of England index-linked data. A second direct-cost analysis evaluating the incremental cost-effective ratio (ICER) was modelled using the 2016 national mean (baseline) IVF and IUI success rates.OUTCOME MEASURES: LB, risks from IVF and IUI, and costs to gain 1 LB.RESULTS: This largest comprehensive analysis integrating success, risks and costs at a national level shows IUI is safer and more cost-effective than IVF treatment.IVF LB/cycle success was significantly better than IUI at 26.96% versus 11.49% (p<0.001) but the IUI success is much closer to IVF at 2.35:1, than previously considered. IVF remains a significant source of multiple gestation pregnancy (MGP) compared with IUI (RR (Relative Risk): 1.45 (1.31 to 1.60), p<0.001) as was the rate of twins (RR: 1.58, p<0.001).In 2016, IVF maternal and neonatal cost was 115 082 017 compared with 2 940 196 for IUI and this MGP-related perinatal cost is absorbed by the National Health Services. At baseline tariffs and success rates IUI was 42 558 cheaper than IVF to deliver 1LB with enhanced benefits with small improvements in IUI. Reliable levels of IVF-related MGP, OHSS (ovarian hyperstimulation syndrome), fetal reductions and terminations are revealed.CONCLUSION: IUI success rates are much closer to IVF than previously reported, more cost-effective in delivering 1 LB, and associated with lower risk of complications for maternal and neonatal complications. It is prudent to offer IUI before IVF nationally.

PMID: 32184314 [PubMed in process]

Continued here:
Observational retrospective study of UK national success, risks and costs for 319,105 IVF/ICSI and 30,669 IUI treatment cycles. - DocWire News

Embryology

My life as one of the Gorleston Thomson triplets after being born on TV | Norfolk and Suffolk Lifestyle News – Eastern Daily Press

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PUBLISHED: 06:30 16 March 2020 | UPDATED: 13:44 16 March 2020

Emily Thomson

Growing up as a triplet. (from left to right) Emily Thomson, Megan Thomson and Georgia Thomson. Picture: Emily Thomson

Emily Thomson

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First let me get something out of the way. When someone asks me 'what is it like to be a triplet?' It's like asking 'what is it like to be me?' - I don't know any different.

Since before I can remember we have been referred to as 'the triplets', whether that was in school, by family members, friends or anyone who couldn't be bothered to say Emily, Megan and Georgia.

We are a single entity where one does not exist without the other - which is great when you're getting picked on in the playground and you have immediate backup but not when we are given a single birthday present and told 'it's to share'.

There are obvious difficulties with having three girls who are exactly the same age, from the terrible twos to moody adolescent teens, but my mum and dad, Sharon and Simon, did a pretty good job and I think they just about managed to keep their sanity.

'Dad they found another one'

My parents were originally told their chances of having another child, after having my brother Troy, were slim so they turned to In Vitro Fertilisation (IVF).

At that time, in 1996, my mum was told the success rate for IVF treatment was around 20pc, slightly lower compared to recent figures which reveal the chances of a live birth for a woman under 35 is 29pc.

But little did they know that their wish for a bigger family was about to be granted - and with a bit more than they bargained for.

To increase their chances of conceiving, doctors put three fertilised eggs back into my mum's womb and luckily for her all three worked.

The odds of conceiving triplets naturally is about 1 in 9,000, but in 1998 triplet births peaked in the UK with 297 because of IVF treatment.

Today the Human Fertilisation and Embryology Act (HFEA) has limited the number of embryos that can be transplanted, to prevent multiple births which have greater risks for the baby and mother.

My mum said: 'At one of the first scans they thought I was having twins. But I went back about a month later and they told me it was triplets. I didn't cry I just remember laughing.

'Simon was offshore at the time but when he got home I couldn't tell him because I was giggling hysterically and Troy just said, 'Dad they have found another one'.'

'I saw you on telly!'

Preparing for the arrival of a new baby can be an exciting and stressful time. Hormones are raging, ankles are swelling, and tempers are getting shorter. On top of that, my parents definitely didn't do things by halves, and from four months pregnant to one month before our arrival, ITV Anglia's cameras followed them around.

Then, on December 16, 1996, at the James Paget Hospital in Gorleston, the whole of Norfolk witnessed our birth.

Looking back at the footage is rather comical with the 90s hairdo's and my then 10-year-old brother wiping our bums and trying to muster some sort of excitement in front of the cameras. My family was literally the talk of the town. And 23 years later, Troy still thinks he was the star of the show.

My mum said: 'As soon as I went out with the triple buggy everybody stopped me and would want to know all about you or say they saw you on the TV. Getting from A to B was always quite a challenge.

'But I'm glad we did it. It's a really special thing that we have all the footage to look back on.'

You've got a friend in 'three'

The best thing about being a triplet growing up is that you were never alone. It was like a permanent sleep over with your best friends.

Bored? - always someone to play with.

Accidentally broken mum's new lipstick? - Blame someone else.

Argument with Georgia? - Megan, you're my new favourite.

We called ourselves the Power Puff Girls (also our favourite cartoon) because although we are not identical and are all completely different - from our hair colour to our friends at school - together we made the best team.

But that's not to say we haven't had our fair share of arguments and hair pulling over the years.

I asked my mum and dad to list some of their favourite memories of all of us in action.

Mum said: 'When you were quite young you worked out how to get over the stair gate by one standing on top of the other or you would push one another over by their bum.

'And at night you would climb into each other's cots because you didn't want to be on your own.

'On a Sunday I would make a roast and the family would sit around the table all afternoon and you would put on a show.

'Megan would be on the drums going mad. Georgia was obsessed with Shakira so she would be dancing and shaking her hips and Emily would be singing. You would have us in stitches.'

Dad added: 'I would come home from offshore and as I walked through the heliport, I saw three little girls darting towards me shouting daddy, daddy, daddy!

'There are so many moments we could list, but you were just best buddies and were forever causing mischief together. Even though you are all very different you have always had each other's backs.'

'Your poor mum!'

As an offshore worker, my dad spent a lot of his time away from home to provide for us all, leaving my mum, Troy and nan to juggle the workload. My mum shares both her struggles and the joy of raising a big family:

'The normal everyday things you take for granted were hard work, getting three babies ready and into car seats or a buggy. If I went shopping, someone would have to come with me because the buggy wouldn't fit through shop doors.

'I couldn't fit three of you into one trolley as well as the shopping so we had to use two trolleys. Everyday things were a lot harder because I couldn't physically manage you on my own.

'When I used to feed you it was like three little birds with their mouths open and I would go along the line and put a spoon in each mouth.

'But the guilt was the hardest thing. I had an only child before and I knew the attention Troy was used to.

'I couldn't cuddle any of you as much because I had so much to do. I was always on the go with bottles, cloth washing and nappy changing.

'But my solace was that you were never alone because you always had each other.

'The best part is I have three amazing daughters I am so proud of achieving everything they are putting their minds and hearts to.

'I like having a full house when the family is together. There is a lot to be said for having a big family, I just happened to get it over with in one big hit.'

A bond that can't be broken

Today I hear 'the triplets' less and less as we live apart and focus on our careers and lives as individuals.

I live in Norwich and work in journalism, Megan lives in Chester and works in law and Georgia is a cross-fit champion in Gorleston focusing on becoming a swimming teacher.

But after being cramped in a womb together you form a bond that not even time or distance can break, and I will always be grateful for that.

It's hard to summarise 23 years of life as a triplet and although it is somewhat of a unique story we are just a normal family - whatever that means.

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My life as one of the Gorleston Thomson triplets after being born on TV | Norfolk and Suffolk Lifestyle News - Eastern Daily Press

Embryology

Merck conducts health media training in partnership with first lady of Namibia – Devdiscourse

Merck Foundation (Merck-Foundation.com) announces the First Lady of Namibia as Ambassador of Merck more than a Mother; Merck Foundation Calls for Applications in Namibia for "Merck More than a Mother" Media Recognition Awards 2020 for English speaking countries to break infertility stigma; Merck Foundation also Calls for Applications for 'Merck More Than a Mother' Fashion Awards from Namibia and rest of Africa.

Merck Foundation, the philanthropic arm of Merck KGaA Germany launched their programs and conducted their first "Merck Foundation Health Media Training" in Windhoek, Namibia in partnership with H.E. MONICA GEINGOS, The First Lady of Namibia and the Ambassador of Merck More Than a Mother together with Ministry of Health and Ministry of Education to break the stigma around infertility and build healthcare capacity in Namibia and rest of Africa.

Talking about the Health Media Training program Dr. Rasha Kelej, CEO of Merck Foundation and President of Merck More Than a Mother explained, "The Health Media Training program is a part of 'Merck More than a Mother' community awareness Program and is organized for the first time in Namibia for local media representatives and media students to emphasize they're critical role to create a culture shift and to be the voice of the voiceless in order to break the stigma around infertile women".

The First Lady of Namibia, H.E. Monica Geingos emphasized, "I am very excited to be appointed as ambassador of 'Merck more than a Mother' and to officially launch Merck Foundation programs in our country. Moreover, I am very happy to host this important training program. Media plays an important role in sensitizing our society. It can help in creating awareness about female & male infertility and in breaking the stigma around infertility".

The Health Media Training program is a part of 'Merck More than a Mother' community awareness Program and is organized for the first time in Namibia"It is important to initiate this important training program as I strongly believe that media has the capacity and ability to break the silence in our communities in a regular and effective basis." Dr. Rasha Kelej added.

The training was addressed by Fertility specialists who are Merck Foundation Alumni and stalwarts of Media.

It provided a great opportunity for journalists to listen to childless women's experience with infertility stigma and to meet the experts and also to network with each other and work as a unit to eradicate the stigma around infertility and its resulted domestic violence in Namibia and rest of Africa.

Merck Foundation together with Namibia's First Lady acknowledged the graduates of Merck Foundation programs in different fields of Oncology, Fertility and Embryology, Diabetes and Hypertension. and welcomed to be Merck Foundation Alumni for Namibia.

Merck Foundation in partnership with the Ministry of Health of Namibia has provided training for doctors from Namibia to be the first oncologist and fertility specialist in the public sector in the country. Moreover, they provided a year's online diploma in cardiovascular preventive medicines and a master's program in diabetes management for two doctors. Merck Foundation has committed to continue providing these specialty training to more doctors from different provinces in Namibia.

Merck Foundation recently announced the winners of 'Merck More Than a Mother' Media Recognition Awards 2019. They also announced for Namibian Media, the Call for Application of "Merck More Than a Mother" Media Recognition Awards 2020 for English speaking countries. The aim of these awards is to emphasize the role of media in enhancing the public engagement and understanding of infertility stigma and the need to change its social perception in African communities.

The applications are invited by media professionals to showcase along the year throughout their work to raise awareness about infertility prevention and breaking infertility stigma.

(With Inputs from APO)

Download The Devdiscourse News App for Latest News.

See the article here:
Merck conducts health media training in partnership with first lady of Namibia - Devdiscourse