Recipient screening in IVF: First data from women undergoing anonymous oocyte donation in Dublin

BACKGROUND: Guidelines for safe gamete donation have emphasised donor screening, although none exist specifically for testing oocyte recipients. Pre-treatment assessment of anonymous donor oocyte IVF treatment in Ireland must comply with the European Union Tissues and Cells Directive (Directive 2004/23/EC). To determine the effectiveness of this Directive when applied to anonymous oocyte recipients in IVF, we reviewed data derived from selected screening tests performed in this clinical setting. METHODS: Data from tests conducted at baseline for all women enrolling as recipients (n = 225) in the anonymous oocyte donor IVF programme at an urban IVF referral centre during a 24-month period were analysed. Patient age at programme entry and clinical pregnancy rate were also tabulated. All recipients had at least one prior negative test for HIV, Hepatitis B/C, chlamydia, gonorrhoea and syphilis performed by her GP or other primary care provider before reproductive endocrinology consultation. RESULTS: Mean (±SD) age for donor egg IVF recipients was 40.7 ± 4.2 yrs. No baseline positive chlamydia, gonorrhoea or syphilis screening results were identified among recipients for anonymous oocyte donation IVF during the assessment interval. Mean pregnancy rate (per embryo transfer) in this group was 50.5%. CONCLUSION: When tests for HIV, Hepatitis B/C, chlamydia, gonorrhoea and syphilis already have been confirmed to be negative before starting the anonymous donor oocyte IVF sequence, additional (repeat) testing on the recipient contributes no new clinical information that would influence treatment in this setting. Patient safety does not appear to be enhanced by application of Directive 2004/23/EC to recipients of anonymous donor oocyte IVF treatment. Given the absence of evidence to quantify risk, this practice is difficult to justify when applied to this low-risk population

The evolution of health policy guidelines for assisted reproduction in the Republic of Ireland, 2004-2009

This analysis reports on Irish regulatory policies for in vitro fertilisation (IVF) from 2004-2009, in the context of membership changes within the Medical Council of Ireland. To achieve this, the current (2009) edition of the Guide to Professional Conduct & Ethics was compared with the immediately preceding version (2004). The statutory composition of the Medical Council from 2004-2009 was also studied. Content analysis of the two editions identified the following differences: 1) The 2004 guide states that IVF "should only be used after thorough investigation has failed to reveal a treatable cause of the infertility", while the 2009 guide indicates IVF "should only be used after thorough investigation has shown that no other treatment is likely to be effective"; 2) The 2004 stipulation stating that fertilized ovum (embryo) "must be used for normal implantation and must not be deliberately destroyed" is absent from the 2009 guidelines; 3) The option to donate "unused fertilised ova" (embryos) is omitted from the 2009 guidelines; 4) The 2009 guidelines state that ART should be offered only by "suitably qualified professionals, in appropriate facilities, and according to the international best practice"; 5) The 2009 guidelines introduce criteria that donations as part of a donor programme should be "altruistic and non-commercial". These last two points represent original regulatory efforts not appearing in the 2004 edition. The Medical Practitioners Act 2007 reduced the number of physicians on the Medical Council to 6 (of 25) members. The ethical guidelines from 2004 preceded this change, while the reconstituted Medical Council published the 2009 version. Between 2004 and 2009, substantial modifications in reproductive health policy were incorporated into the Medical Council's ethical guidelines. The absence of controlling Irish legislation means that patients and IVF providers in Ireland must rely upon these guidelines by default. Our critique traces the evolution of public policy on IVF during a time when the membership of the Medical Council changed radically; reduced physician contribution to decision-making was associated with diminished protection for IVF-derived embryos in Ireland. Considerable uncertainty on IVF practice in Ireland remains

Oblique fluorescence in a MARS scanner with a CdTe-Medipix3RX

The latest version of the MARS small bore scanner makes use of the Medipix3RX ASIC, bonded to a CdTe or CZT semi-conductor layer, to count x-ray photons and create a spectroscopic CT data set. The MARS imaging chain uses the energy-resolved 2D transmission images to construct quantitative 3D spectral and material images. To improve the spectral performance of the imaging system it is important that the energy response of the detector is well calibrated. A common methodology for energy calibration is to use x-ray fluorescence (XRF), due to its effective monochromatic nature. Oblique (off-axis) XRF can be measured in situ in the MARS small bore scanner. A monoatomic foil is placed in front of the x-ray source and off-axis XRF is measured. A key issue is identifying near optimal measurement positions that maximize the XRF signal while minimizing transmitted and scattered x-rays from the primary beam. This work shows the development of a theoretical model that is able to identify where in the detector plane XRF is maximum. We present: (1) a theoretical model that calculates the XRF photon distribution across the detector plane produced from illuminated foils attached to the scanner’s filter bar; (2) preliminary experimental measurements of the XRF distribution outside of the main beam taken with a CdTe-Medipix3RX detector; and (3) a comparison between the model and experiment. The main motivation behind creating this model is to identify the region in the detector plane outside of the main beam where XRF is at a maximum. This provides the optimum detector location for measuring a monochromatic XRF source with minimal polychromatic contamination for its use in per-pixel energy calibration of Medipix3RX detectors in MARS scanners

Per-pixel energy calibration of photon counting detectors

Energy resolving performance of spectral CT systems is influenced by the accuracy of the detector’s energy calibration. Global energy calibration maps a given threshold to the average energy response of all pixels of the detector. Variations arising from CMOS manufacturing processes and properties of the sensor cause different pixels to respond differently to photons of the same energy. Threshold dispersion adversely affects spectral imaging by degrading energy resolution, which contributes to blurring of the energy information. In this paper, we present a technique for per-pixel energy calibration of photon-counting x-ray detectors (PCXDs) that quantifies the energy response of individual pixels relative to the average response. This technique takes advantage of the measurements made by an equalized chip. It uses a known global energy map to quantify the effect of threshold dispersion on the energy response of the detector pixels across an energy range of interest.The proposed technique was assessed using a MARS scanner with an equalized Medipix3RX chip flip-bonded to 2mm thick CdTe semiconductor crystal at a pitch of 110ᵤm. Measurements were made of characteristic x-rays of a molybdenum foil. Results were compared between the case that the global calibration was used on its own and the case of using it in conjunction with our per-pixel calibration technique. The proposed technique quantified up to 1:87 keV error in energy response of 100 pixels of a selected region of interest (ROI). It made an improvement of 28:3% in average FWHM. The additional information provided by this per-pixel calibration technique can be used to improve spectral reconstruction

A New Boson with a Mass of 125 GeV Observed with the CMS Experiment at the Large Hadron Collider

The Higgs boson was postulated nearly five decades ago within the framework of the standard model of particle physics and has been the subject of numerous searches at accelerators around the world. Its discovery would verify the existence of a complex scalar field thought to give mass to three of the carriers of the electroweak force-the W+, W-, and Z 0 bosons-as well as to the fundamental quarks and leptons. The CMS Collaboration has observed, with a statistical significance of five standard deviations, a new particle produced in proton-proton collisions at the Large Hadron Collider at CERN. The evidence is strongest in the diphoton and four-lepton (electrons and/or muons) final states, which provide the best mass resolution in the CMS detector. The probability of the observed signal being due to a random fluctuation of the background is about 1 in 3 x 106. The new particle is a boson with spin not equal to 1 and has a mass of about 1.25 giga-electron volts. Although its measured properties are, within the uncertainties of the present data, consistent with those expected of the Higgs boson, more data are needed to elucidate the precise nature of the new particle