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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).

PARI Pharma Reports Successful Phase Ib Clinical Results For Inhaled Liposomal Cyclosporine A
This month"s Journal of Aerosol Medicine and Pulmonary Drug Delivery features positive Phase Ib clinical trial results for PARI Pharma"s L-CsA, inhaled liposomal cyclosporine A. In May, PARI Pharma received Orphan Drug Designation from the Food and Drug Administration for L-CsA, delivered via an Investigational eFlow Nebulizer System, for the prevention and treatment of bronchiolitis obliterans, a devastating, incurable disease of the small airways affecting approximately 60,000 patients worldwide.
News of the day
Urologist And Allergist Explore Link Between Allergies And Interstitial Cystitis
Allergy testing and treatment may offer a new therapeutic option for many patients with interstitial cystitis (IC). IC is a severely painful bladder condition affecting as many as 8 million women and 1.5 million men in the United States. Patients and the providers who treat them have long noticed a correlation between allergies and IC. Recently, a urologist and allergist in Louisville, Kentucky, began to explore the link between these two chronic ailments to provide patients with more effective treatment. The story of their discoveries is featured in the ICA Update, the quarterly magazine of the Interstitial Cystitis Association (ICA).
Public Health

CMS Rates Nursing Homes

The Wall Street Journal reports that "the federal government is stepping up efforts to improve the quality of nursing-home care and now has an online tool consumers can use in evaluating facilities. The Centers for Medicare and Medicaid Services, or CMS, will begin a pilot program this summer to see if cash incentives to nursing homes can improve the care they provide, especially in areas such as nurse staffing and preventable hospitalizations." In a separate effort, CMS started the Nursing Home Compare system in December to rank 16,000 nursing facilities based on government inspection results, staffing data and quality measures. The Wall Street Journal reports that "about three million Americans need nursing-home care at some point each year, and the care is often costly. Unlike with most other health-care needs, many elderly and disabled Americans have to pay for nursing homes themselves, either because they earn too much to qualify for Medicaid or they don"t qualify for Medicare"s coverage." The Journal pointed out that "many seniors are surprised by Medicare"s limited coverage for nursing-home care: up to 100 days after a hospitalization of three days or more," noting that "the beneficiary pays nothing during the first 20 days at a nursing home, $133.50 a day after that and the full cost after 100 days." Consumer groups warn people to research facilities because care can vary widely (Zhang, 6/1). 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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