A new study has found that IVF treatments for the most severe forms of male infertility are associated with an increased risk of intellectual disability and autism in children.

Autism and intellectual disability remain a rare outcome of IVF, and whilst some of the risk is associated with the risk of multiple births, the study provides important evidence for parents and clinicians on the relative risks of modern IVF treatments.
The study is the largest of its kind and was led by researchers at King`s College London (UK), Karolinska Institutet (Sweden) and Mount Sinai School of Medicine in New York (USA).

By using anonymous data from the Swedish national registers, researchers analysed more than 2.5 million birth records from 1982 and 2007 and followed-up whether children had a clinical diagnosis of autism or intellectual disability (defined as having an IQ below 70) up until 2009.

Of the 2.5m children, 1.2 percent (30,959) were born following IVF. Of the 6,959 diagnosed with autism, 103 were born after IVF; of the 15,830 with intellectual disability, 180 were born after IVF.

Multiple pregnancies are a known risk factor for pre-term birth and some neurodevelopmental disorders, so the researchers also compared single to multiple births.

Sven Sandin, co-author of the study from King`s College London`s Institute of Psychiatry said, "IVF treatments are vastly different in terms of their complexity. When we looked at IVF treatments combined, we found there was no overall increased risk for autism, but a small increased risk of intellectual disability. When we separated the different IVF treatments, we found that `traditional` IVF is safe, but that IVF involving ICSI, which is specifically recommended for paternal infertility is associated with an increased risk of both intellectual disability and autism in children."

Compared to spontaneous conception, children born from any IVF treatment were not at an increased risk of autism, but were at a small increased risk of intellectual disability (18 percent increase - from 39.8 to 46.3 per 100,000 person years).

However, the risk increase disappeared when multiple births were taken into account.

Secondly, the researchers compared all 6 different types of IVF procedures available in Sweden - whether fresh or frozen embryos were used; if intracytoplasmic sperm injection (ICSI) was used, and if so, whether sperm was ejaculated or surgically extracted.

Developed in 1992, ICSI is recommended for male infertility and is now used in about half of all IVF treatments.

The procedure involves injecting a single sperm directly into an egg, rather than fertilization happening in a dish, as in standard IVF.

Children born after IVF treatments with ICSI (with either fresh or frozen embryos) were at an increased risk of intellectual disability (51 percent increase - 62 to 93 per 100,000).

This association was even higher when a preterm birth also occurred (73 percent increase - 96 to 167 per 100,000). Even when multiple and pre-term births were taken into account, IVF treatment with ICSI and fresh embryos was associated with an increased risk of intellectual disability (66 percent increase for singleton birth, term birth following ICSI with fresh embryos- 48 to 76 per 100,000).

Children born after IVF with ICSI using surgically extracted sperm and fresh embryos were at an increased risk of autism (360 percent increase - 29 to 136 per 100,000) but the association disappeared when multiple births were taken into account.

The study is published in JAMA.

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has welcomed the World Health Organization (WHO)`s new HIV/AIDS treatment and prevention guidelines. For the first time, the 2013 guidelines would combine recommendations across the continuum of HIV care and prevention programs, including expanding treatment eligibility for HIV-positive pregnant women, mothers, and children. These recommendations signify a major step forward in the global effort to achieve an AIDS-free generation, but will require a significant shift in current implementation efforts.

"Implementing these new guidelines will require thoughtful leadership and planning" said R.J. Simonds, M.D., vice president of program innovation and policy at EGPAF. "We must listen to the local communities and involve them in the rollout efforts. These guidelines have the opportunity to provide unprecedented access to treatment and prevention measures and reduce HIV/AIDS transmission rates worldwide."

The new guidelines include recommendations to provide lifelong antiretroviral therapy (ART) for all pregnant and breastfeeding women, also known as Option B+, which are expected to improve prevention of mother-to-child transmission (PMTCT) services and increase the likelihood that infants born to HIV-positive mothers will be born and remain HIV-negative. In addition, lifelong ART has the potential to improve the health and livelihood of HIV-positive mothers and reduce the spread of infection to uninfected partners.

The guidelines also call for expanded pediatric treatment, including immediate initiation of ART for all HIV-positive children younger than five years of age. This new recommendation shines a light on efforts to treat new and existing pediatric HIV infections, a component that is often overlooked in the global HIV/AIDS response.

"Currently, only one in three eligible children living with HIV receives the medicines they need. We hope the new guidelines will focus increased attention and efforts to eliminate this gap," said Laura Guay, M.D., vice president of research at EGPAF.

"In addition, because of the many novel aspects of the guidelines, studying its translation into practice is essential for achieving its potential."

Globally, an estimated 26 million people living with HIV in low-and middle-income countries will be eligible for ART under the new guidelines, compared with the previous 17 million eligible recipients in accordance with the WHO`s 2010 guidelines. Full implementation could avert as many as 3 million AIDS-related deaths and 3.5 million new HIV infections between 2013 and 2025.
"The new recommendations embody the continuing evolution of the global HIV/AIDs response," said EGPAF President and CEO Charles Lyons. "As we work to combat this epidemic, we must be willing to change and expand upon current treatment and prevention efforts to reach as many HIV-positive people as possible. The Foundation supports efforts to implement these guidelines as we continue our mission to eliminate pediatric HIV and create a world free of HIV/ AIDS."

Milk of Magnesia, used to solve problems of indigestion, ulcers and upset stomachs, has been banned, as it contains too much sulphate.

GlaxoSmithKline GSK stopped manufacturing the product last autumn but were allowed to sell their supplies, the Daily Express reported.

The stockpiles have gone so low that the bottles are being sold for up to 20 pounds, which is about 10 times their normal price, on eBay.

GSK is believed to be changing the recipe to comply with the EU limit.

About 7.4 million people will be saved from premature death by 2050 due to the tobacco control measures, which have been put in place in 41 countries between 2007 and 2010, a new study has revealed.

The study demonstrates the success of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in reducing tobacco use and, thus, saving lives.

Lead author David Levy, PhD, professor of oncology at Georgetown Lombardi Comprehensive Cancer Center in Washington, said that it is a spectacular finding that by implementing these simple tobacco control policies, governments can save so many lives.


Known as "MPOWER," the measures correspond to one or more of the demand reduction provisions included in the WHO FCTC: Monitoring tobacco use and prevention policies, Protecting people from tobacco smoke, Offering help to quit tobacco use, Warning people about the dangers of tobacco, Enforcing bans on tobacco advertising, Promotion and sponsorship, and Raising taxes on tobacco.

The authors did a modeling exercise and projected the number of premature deaths that would be averted by 2050 through the implementation of one or more of these measures.

Levy said that in addition to some 7.4 million lives saved, the tobacco control policies that they examined could lead to other health benefits like lesser adverse birth outcomes related to maternal smoking, including low birth weight, and reduced health-care costs and less loss of productivity due to less smoking-related disease.

If these high-impact tobacco control measures were implemented even more widely, millions more smoking-related deaths would be averted, Douglas Bettcher, MD, director of the department of non-communicable diseases at WHO, said.

Bettcher said that the tobacco use is the single most preventable cause of death in the world, with six million smoking-attributable deaths per year today, and these deaths are projected to rise to eight million a year by 2030, if current trends continue.
The study has been published in the Bulletin of the World Health Organization.