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    英国独立报2006年10月8日消息——准备受孕的妇女们要为使用未规定剂量的IVF新药付上数千英镑，而这些药物可能根本就不必要，而且还会对健康有害。

    伦敦圣乔治医院生殖医学负责人Geeta Nargund，是卫生保健慈善机构与生育专家中的一员。这些专家们对IVF治疗中药物的过度使用表示担心。Nargund呼吁英国政府尽快加强这些药物的管理。

    她在10月7日谈到，许多诊所使用高剂量激素来刺激产卵、使胚胎植入易于进行，但这使得准妈妈的健康受到威胁。她说：“这是唯一一个药物未受管制出现的空区，是错误的做法。我们已推荐了参考剂量，但是他们未依此加强使用约束，而且一些诊所超过了这些水平。”

    每年有超过10,000个儿童通过IVF治疗而生，他们的妈妈接受了药物以刺激卵巢产生更多的卵子。而这些激素可引起卵巢过度刺激综合征，这影响了多达6％的患者。今年8月在莱彻斯特皇家医院就有一位患者死于该综合征。

    Nargund女士呼吁对IVF相关的长期健康问题要进行更多的深入研究。“我们对刺激卵巢产生更多卵子带来的风险有很多顾虑，”她说。“这可能会使女性以后患生殖器官疾病，尤其是子宫癌，我们急切需要资助研究来验证这些疑问。”

    英国政府将于年底举办有关自然周期IVF与半自然IVF的首次国际科学会议。自然周期体外受精是IVF的最初形式，是将卵子从不经药物刺激的女性体内取出。半自然周期IVF，是使用低剂量药物来刺激产卵。

    自然方法的成功率在7%到10%，而使用药物的成功率为25%-30%。Nargund女士说：“自然周期IVF的成功率低于受刺激疗法，但作为医生，我认为我们应针对每个妇女的个人情况，来权衡二者的利弊。目前药物的花费远远高于治疗本身，少至每个周期400英镑，多达1200英镑。少使用药物，治疗更便宜，NHS（英国国民医疗服务系统）就可为提供更多人提供治疗。

    自然周期IVF源于一个卵泡的自然发育，因此通常只能提出一个卵子。Louise Brown，世界第一例“试管婴儿”，25年前就是用此方法被孕育的。

    IVFWorld，一个独立的生育组织，昨天说：“自然IVF周期已被证实切实可行。它既便宜，风险又小。许多诊所和制药公司从这些药物中牟取巨额利润，因此他们对提倡自然疗法不感兴趣。”

    案例研究：“可怕的副作用”

    Elaine Rider发现做IVF“像是一场噩梦”。 这位来自牛津郡的市场经理和她的丈夫Dave，一位工程师，八年来一直打算要一个孩子。“IVF药物让我备受头疼折磨、情绪不稳、眼前出现黑点。我的健康状况明显恶化。我做过4次IVF，每一次的副作用都不同。前三次都有过卵巢囊肿。他们每一次都改变药物使用。这绝对算的上是我此生的最痛苦的事。我每个周期都要付2680英镑，如此昂贵，但每次都无效，又是多么的令人失望。因为我已经超过35岁了，我和丈夫不得不自己养活自己。不过即使治疗的每个程序都非常困难，我还会再尝试。媒体给大众的印象是，IVF是万能的。实际上，成功的机会很小，低于25%。我对自然周期IVF不了解，因为医生从来没有讲过。”

IVF: Why leading fertility expert thinks women are being put at risk
High doses of hormones used to help patients produce eggs could harm their health - and may not even be necessary
By Adele Waters
Published: 08 October 2006

Women trying to get pregnant are paying thousands of pounds for unregulated doses of new IVF drugs that may be unnecessary and harmful to health.

The head of reproductive medicine at St George's Hospital in London, Geeta Nargund, has joined the ranks of healthcare charities and fertility experts who are alarmed at the overuse of drugs in IVF treatment. She is calling for the urgent regulation of these drugs in the UK.

Mrs Nargund said yesterday that many clinics endanger the health of would-be mothers with high doses of hormones to stimulate egg production as well as steroids used to aid the implantation of embryos. She said: "This is the only area of medicine where drug dosages are not regulated, and that's wrong. We have recommended doses but they are not binding and some clinics are exceeding these levels."

More than 10,000 children are born each year using IVF treatments in which mothers are given drugs to stimulate their ovaries to produce a larger number of eggs. These hormones can cause ovarian hyperstimulation syndrome, which affects up to 6 per cent of patients. In August a woman died of the syndrome at the Leicester Royal Infirmary.

Mrs Nargund urges more research into the long-term health problems associated with IVF. "We have concerns regarding the risk of stimulating ovaries to produce more eggs," she said. "There may be consequences for a woman's reproductive organs in later life, in particular uterine cancer, and we urgently need to fund studies to test these suspicions."

The UK will host the first world scientific congress later this year on natural-cycle IVF - the original form of IVF, in which eggs are extracted from a woman's body without drugs - and semi-natural IVF, which uses low-dose drugs to stimulate egg production.

Natural methods have success rates of between 7 and 10 per cent, compared with an average of 25 to 30 per cent with drugs. Mrs Nargund said: "Success rates of natural-cycle IVF are lower than with stimulated cycles, but I believe as doctors we should treat each woman individually, balancing the risk and benefits of treatment in each case. Drugs can cost far more than the treatment itself, from as little as £400 per cycle up to £1,200. By using fewer drugs, we would make the cycles cheaper and the NHS could offer more treatment cycles."

Natural-cycle IVF relies on the spontaneous development of one follicle only and therefore the retrieval of, usually, only one egg. Louise Brown, the world's first "test-tube baby", was conceived using this method 25 years ago.

IVFworld, an independent fertility organisation, said yesterday: "Natural IVF cycles have been proven to work. It's cheaper and less risky. A lot of the clinics and drugs companies make huge profits from these drugs, so it's not in their interest to promote natural methods."

Case Study: 'Terrible side effects'

Elaine Rider found having IVF "a nightmare". The marketing manager from Oxfordshire and her husband Dave, an engineer, have been trying for a baby for eight years. "The [IVF drugs] gave me excruciating headaches, mood swings and spots in front of the eyes. My general health definitely deteriorated. I have tried IVF four times and each time the side effects are different. I also got ovarian cysts the first three times I had it. Each time they changed the drugs that were used. It's definitely been the biggest rollercoaster ride of my life. I've had to pay £2,680 for each cycle. It's very dear and a huge disappointment when each time it does not work. As I'm over 35, my husband and I have to pay for everything ourselves. I will try again though, even though each course of treatment is very hard. The media give the impression that IVF is a panacea. In fact the chance of success is quite low for each treatment, less than 25 per cent. I didn't know about natural IVF, as doctors never offered it."
Tom Anderson

文章来源：http://news.independent.co.uk/uk/health_medical/article1819653.ece

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