The employees of the University Medical Center in Utrecht made a fatal mistake. Over 20 women were ignited by the wrong man’s seed. The case was publicized by BBC News and the university euphemistically calls it “procedural errors”.
Women who were treated at a Dutch infertility center fell victim to the negligence of its staff. In addition, not one-time, because “mistaken” fertilization was carried out there between April 2015 and November 2016. The center carries out almost 700 IVF treatments annually, he told PAP.
Fertilization occurs by inserting the sperm directly into the cytoplasm of the ovum (ICSI – Intracytoplasmic sperm injection) with a pipette.
The center in Utrecht issued a statement in which it informs that during fertilization, sperm intended for surgery performed on one of the couples could have ended up in the eggs of 26 other couples. Therefore, it is possible that these cells were fertilized by someone else’s sperm than intended.
Although the chances of such an event were slim, “they cannot be ruled out” – said the spokesman for the Center.
One technician was using a pipette to insert sperm in the wrong way. Although he changed the pipettes every time, he always used the same rubber cap (nipple). When he found traces of semen on it, he sounded the alarm. The rubber part should have a special filter, but this one didn’t.
Four of the women who underwent the wrong procedure are pregnant and nine have already given birth. The women and their partners were informed about the situation – they will soon meet the doctors of the Center and will be offered DNA tests. The remaining 13 embryos are still frozen. Freya, a Dutch support group for people struggling to conceive, is shocked at reports of mistakes made. “The desire to have a baby is a very delicate matter, especially when it is not about normal conception in the bedroom. That is why people need 100% certainty about the chosen method, ”he emphasizes.
In 2012, a Singapore mother sued a clinic that mistook her husband’s sperm sample for someone else’s. Doubts arose when she saw her child, who had a distinctly different skin and hair color from her husband (mother is Chinese, father – white), and the blood test was decisive. Mother was in group 0, father was in group A, and child was in group B, which is biologically impossible.
An alternative IVF version has been successfully used in the UK. And the first child thus conceived was born into the world. In Poland, Medexpress was the first to write about this method:
“In a standard in vitro procedure, the ovaries are usually stimulated to produce oocytes with an injection of human chorionic gonadotrophin (hCG).
It is not always safe. In about 1 percent. women develop a complication in the form of ovarian hyperstimulation syndrome (OHSS). The ovaries, overstimulated with artificial gonadotropin, then produce many eggs during one cycle, there is fluid in the abdominal cavity, water and electrolyte disturbances and blood coagulation disorders, abdominal pain, shortness of breath. OHSS is most often mild, but there are also severe and even fatal cases. The risk is higher in patients with polycystic ovary syndrome.
In a new variant in vitro, kisspeptin, a natural hormone encoded by the KISS-1 gene, was used to stimulate the ovaries instead of hCG. Kisspeptin allows the ovaries to release eggs in a gentler, more controllable way.
The first trials with the use of kisseptin in the in vitro procedure in humans were carried out by prof. Waljit Dhillo of Imperial College London and Dr. Geoffrey Trew of London’s Hammersmith Hospital. 30 women participated in the study. Kisspetin worked in 29, and 28 of them were able to use their eggs for in vitro fertilization. In April this year. a boy named Heath was born – the world’s first child born thanks to the new method.
The authors of the study note, however, that it may still be many years before the use of kisspetin in the procedure of IVF fertilization becomes the standard. Before that, it will be necessary to conduct a series of tests that will confirm the effectiveness and safety of the method on a larger group of women ».
What is naprotechnology?
In Poland, more and more couples decide not to use IVF, but to use naprotechnology. It is chosen by couples who are not allowed to IVF through their worldview. Unofficially, it is said that also those that have failed in vitro tests. Because while it seems like a miracle treatment for infertility, the truth is that most couples who choose to do so never become parents.
Father of NaProTechnology, American gynecologist prof. In the 70s, TW Hilgers developed a fertility recognition method using symptoms assessed by a woman: cervical mucus, vaginal discharge, intensity of menstrual bleeding.
It was an extension of the idea of the Australian neurologist J. Billings and his wife, a pediatrician, who, at the priest’s request, prepared a natural way of family planning. They noted the variability of the mucus produced by the cervix in the ovulatory cycle. These observations, supported by research on hormones secreted in particular phases of the cycle, allowed for the determination of fertile days. Prof. Hilgers developed standards for the use of this method and decided to use it for the treatment of infertility. It turned out that some changes in mucus secretion and menstrual bleeding can be attributed to specific diseases, such as hypothyroidism or hormonal disorders. NaPro Technology differs from standard infertility treatment, apart from self-observation of mucus and strict adjustment of the treatment to the course of the natural ovulatory cycle, by excluding the use of assisted reproductive techniques inconsistent with the position of the Catholic Church, i.e. in vitro. Both methods use modern diagnostic techniques, e.g. the use of a laser in operations, etc.
Maciej Barczentewicz, a gynecologist who has been dealing with NaProTechnology for years, explains that the most important innovation is the precise linking of diagnostics and treatment with the individual cycle of a woman, and then monitoring the effects of treatment. In addition, NaProTechnology assumes the performance of time-consuming and costly surgical procedures that are rarely used in Poland today in the in vitro era, e.g. near contact laparoscopy, i.e. very thorough with meticulous removal of endometriosis foci, special anti-growth techniques or, in the case of obstruction of the fallopian tubes, selective hysterosalpingography. – A healthy body is fertile. If someone is looking forward to having a descendant, he must be diagnosed and, if possible, treated – says Aleksandra Baryła, gynecologist and obstetrician – naprotechnologist from the Specialist Hospital. Holy Family in Warsaw. – This is what medicine should be like. This, however, requires patience and costs money, he adds. We are bound by meticulousness that got lost somewhere in our daily practice, says gynecologist Dr. Ewa S´lizien´-Kuczapska from Warsaw, who uses NaProTechnology. “It is true that 50% of the couples we treat would have children regardless of our actions, but half have a specific problem diagnosed and resolved,” he explains. Doctors using NaProTechnology must undergo a special course. Then there is a six-month practice supervised by NaProTechnology specialists. There are already dozens of doctors of this specialty in Poland. Their list is available at www.fccp.pl
What does a visit to a naprotechnologist look like?
A medical visit to a gynecologist using NaProTechnology lasts up to one and a half hours. Before that, the couple should have several meetings with the instructor teaching the observation of cervical mucus. The woman’s task is to closely observe the mucus and monitor the bleeding. Instead, body temperature is measured. For the first 2-3 months, almost everyone has trouble implementing systematic cycle observation and daily note-taking. Over time, each of the ladies gains self-confidence and can cope on her own – says certified instructor Dr. Krzysztof Strug. After three months, the couple comes back to the doctor with a completed observation card, where they also note the days when they had sex. The doctor, trying to determine the cause of infertility, orders a number of tests. He is also interested in food intolerances, because being allergic to gluten or protein may also make it difficult to get pregnant. Treatment includes surgical procedures related to the removal of endometriosis, clearing the fallopian tubes and others, an elimination diet, drugs regulating hormone levels, and sometimes vitamin B or D supplementation.
Gynecologist prof. Stanisław Radowicki believes that NaProTechnologists raise too high hopes in patients. In his opinion, it is unethical to convince patients that the treatment of infertility using the NaProTechnology method is so effective that it will solve the problem of every couple struggling with infertility. The supporters of the method emphasize that the effectiveness of in vitro measured by the number of conceptions is approx. 25%, while NaProTechnology – measured by the number of births, on average 71%. Opponents, however, argue that NaProTechnologia is paramedical. – I was once considered a quacker when I ordered the use of antitussive syrup in one of my patients in order to thin the mucus too thick. When she told her friend that she got pregnant, after the doctor told her to take vitamins and cough syrup, she asked her for the address of the quack doctor – she laughs and explains Dr. Baryła. He adds that sometimes a thorough cycle analysis and vitamin supplementation are enough. – All medical procedures that we perform are standard medical procedures. But the dispute is ideological, because for ethical reasons we reject IVF and hence the whole campaign – he explains.
– Of course, we are not able to help everyone, but if approx. 50% of treated couples become parents, then there is a lot – says Dr. Barczentewicz. To the objection that these pairs would have had children even without treatment, he replies: – If, after several years of treatment in different centers, the NaProTechnology used ends with conception, then probably a cause-and-effect relationship can be seen here. – In vitro fertilization is proposed in the so-called spontaneous infertility. I believe that there is no such thing. The cause was not found, because it was not possible, and sometimes it was not looked for at all. For me, infertility is not a disease, but a symptom of one or even several diseases – says Dr. Baryła. Doctors participating in the government’s IVF program emphasize that they use all diagnostic and treatment methods prescribed by NaProTechnology. However, in a situation where they are exhausted and still do not become pregnant, as well as when medicine is helpless, e.g. in the case of permanent dysfunction of the fallopian tubes, some types of male infertility, they suggest IVF. Therefore, comparing the effectiveness of both methods does not make much sense, because in vitro was developed as a procedure used when conventional – pharmacological and surgical methods of infertility treatment fail. The Ministry of Health introduces a “national procreation program”. She believes that the in vitro procedure is not a panacea for fertility problems and cannot replace its treatment.