The Human Fertilisation and Embryology Authority (HFEA) data shows live birth rates for frozen embryo transfer rising above fresh embryo transfer in the latest published report.
The success rates for frozen embryo transfer have steadily been improving for frozen embryo transfer and now exceed fresh embryo transfer live birth rates; which the HFEA has described as an ‘important milestone in the development of IVF’. The latest 2016 data shows a live birth rate per embryo transfer of 22% for frozen, compared to 21% for fresh transfers.
On 29th March 2018, Senior Health Economist Oliver Rivero-Arias will be presenting an OHE Lunchtime Seminar: Valuing Children’s Health for Economic Evaluation.
Economic evaluations of treatments for children have primarily used adult preferences when estimating health benefits. Recent work has demonstrated that using adult values to inform preferences for health states experienced by children or adolescents is not appropriate, and this has raised doubts about the validity of such economic evaluations. Eliciting preferences to be used to inform decisions about health care for younger populations is challenging and presents the questions of whose values should be collected and from which perspective.
In this presentation, Oliver will report the results of two valuation exercises for a child-specific health-related quality of life instrument, comparing preferences elicited from adolescents and adults in the UK and Spain.
A study by Maggie Redshaw and Jane Henderson shows that women living in the most deprived areas in England, who are most at risk of stillbirth, perceived their care more negatively than other women.
In this study, women who had suffered a stillbirth were asked nine months later about their care around the time of the stillbirth. Women resident in the most deprived areas were significantly less likely to feel spoken to so that they could understand and treated with respect. Free text comments indicated that these women had difficulty accessing care, that communication was poor, many of them did not feel cared for, and felt that more could have been done to save their baby.
The study is published in the Birth journal and you can read it here.
New research comparing fresh and frozen embryo transfer by Shi, Y. et. al. (2018) has found that live birth rates are equivalent between the two types of embryo transfer but that frozen embryo transfer significantly lowers the risk of ovarian hyperstimulation syndrome (OHSS).
In this multi-centre randomised controlled trial, 2157 who were undergoing their first IVF were randomly allocated to receive either fresh or frozen embryo transfer. The live birth rate did not differ significantly between the two groups. However, frozen embryo transfer resulted in significantly lower risk of OHSS than fresh embryo transfer (0.6% vs 2.0% relative risk). The risk of other adverse maternal and neonatal outcomes did not differ significantly between the 2 groups.
For more details you can read the full article in The New England Journal of Medicine.
A study by Julie Hennegan, Jane Henderson and Maggie Redshaw shows increased risk of depression and post-traumatic stress disorder (PTSD)-type symptoms in fathers who held their stillborn babies.
In this study, women were asked at nine months whether their partner had seen and held their stillborn baby after birth, and about their partners' subsequent wellbeing. Almost all fathers, 92%, saw their baby, and 82% held them.
At three months, partners who had held their stillborn babies had more than two-and-a-half times the risk of depression, and nearly twice the risk of PTSD-type symptoms compared to those who had not held their stillborn babies, even when comparing partners of similar characteristics. There was weaker evidence at nine months of a difference in outcomes between fathers who had held their stillborn baby and ones that had not, although a trend towards poorer outcomes remained.
You can read the study in the Journal of Reproductive and Infant Psychology.
Current guidelines support offering ‘low risk’ women a choice of birth setting, including a midwifery unit, at home, or in a hospital labour ward or obstetric unit. But how do women choose between these options and what information do they receive and need in order to make a choice?
Women in our study drew on multiple sources of information when choosing where to give birth; their midwife was not their primary source of information. Women wanted to be able to know what their options were early in pregnancy and to be able to consider, explore and discuss these with their midwife throughout their pregnancy, not at a fixed point in time.
You can read the paper which is published in BMC Pregnancy and Childbirth.
The BUMPES trial has been featured on the MoreTrials website in the ‘Trials that matter’ series. BUMPES was led at the NPEU by Ed Juszczak, Pollyanna Hardy and Oliver Rivero-Arias as part of a multicentre collaborative group. Women who had received an epidural anaesthetic were randomised to either an upright or lying down position in the second stage of labour. The primary outcome of the trial was spontaneous vaginal birth.
Women in the lying down group had significantly better chance of spontaneous vaginal birth, and no disadvantages were apparent on the short or longer term for both mother and baby.