Day: February 22, 2024

montgomery, alabama — A second in vitro fertilization provider in the U.S. state of Alabama is pausing parts of its care to patients after the state Supreme Court ruled that frozen embryos are legally considered children. 

Alabama Fertility Services said in a statement Thursday that it has “made the impossibly difficult decision to hold new IVF treatments due to the legal risk to our clinic and our embryologists.” 

The decision comes a day after the University of Alabama at Birmingham health system said in a statement that it was pausing IVF treatments so it could evaluate whether its patients or doctors could face criminal charges or punitive damages. 

“We are contacting patients that will be affected today to find solutions for them and we are working as hard as we can to alert our legislators as to the far reaching negative impact of this ruling on the women of Alabama,” Alabama Fertility said. “AFS will not close. We will continue to fight for our patients and the families of Alabama.” 

Doctors and patients have been grappling with shock and fear this week as they try to determine what they can and can’t do after the ruling by the all-Republican Alabama Supreme Court that raises questions about the future of IVF. 

Alabama Fertility Services’ decision left Gabby Goidel, who was days from an expected egg retrieval, calling clinics across the South looking for a place to continue IVF care. 

“I freaked out. I started crying,” Goidel said. “I felt in an extreme limbo state,”

The Alabama ruling came down Friday, the same day Goidel began a 10-day series of injections ahead of egg retrieval, with the hopes of getting pregnant through IVF next month. She found a place in Texas that will continue her care and plans to travel there Thursday night. 

Goidel experienced three miscarriages and she and her husband turned to IVF as a way of fulfilling their dream of becoming parents. 

“It’s not pro-family in any way,” Goidel said of the Alabama ruling. 

Dr. Michael C. Allemand, a reproductive endocrinologist at Alabama Fertility, said Wednesday that IVF is often the best treatment for patients who desperately want a child, and the ruling threatens doctors’ ability to provide that care. 

“The moments that our patients are wanting to have by growing their families — Christmas mornings with grandparents, kindergarten, going in the first day of school, with little backpacks — all that stuff is what this is about. Those are the real moments that this ruling could deprive patients of,” he said. 

Justices — citing language in the Alabama Constitution that the state recognizes the “rights of the unborn child” — said three couples could sue for wrongful death when their frozen embryos were destroyed in an accident at a storage facility. 

“Unborn children are ‘children’ … without exception based on developmental stage, physical location, or any other ancillary characteristics,” Justice Jay Mitchell wrote in Friday’s majority ruling. Mitchell said the court had previously ruled that a fetus killed when a woman is pregnant is covered under Alabama’s Wrongful Death of a Minor Act and nothing excludes “extrauterine children from the Act’s coverage.” 

While the court case centered on whether embryos were covered under the wrongful death of a minor statute, some said treating the embryo as a child — rather than property — could have broader implications and call into question many of the practices of IVF. 
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WASHINGTON — Alzheimer’s quietly ravages the brain long before symptoms appear, and now scientists have new clues about the dominolike sequence of those changes — a potential window to one day intervene. 

A large study in China tracked middle-aged and older adults for 20 years, using regular brain scans, spinal taps and other tests. 

Compared to those who remained cognitively healthy, people who eventually developed the mind-robbing disease had higher levels of an Alzheimer’s-linked protein in their spinal fluid 18 years prior to diagnosis, researchers reported Wednesday. Then every few years afterward, the study detected another so-called biomarker of brewing trouble. 

Scientists don’t know exactly how Alzheimer’s forms. One early hallmark is that sticky protein called beta-amyloid, which over time builds up into brain-clogging plaques. Amyloid alone isn’t enough to damage memory — plenty of healthy people’s brains harbor a lot of plaque. An abnormal tau protein that forms neuron-killing tangles is one of several co-conspirators. 

The new research, published in The New England Journal of Medicine, offers a timeline for how those abnormalities pile up. 

The study’s importance “cannot be overstated,” said Dr. Richard Mayeux, an Alzheimer’s specialist at Columbia University who wasn’t involved in the research. 

“Knowledge of the timing of these physiological events is critical” for testing new ways of treating and maybe eventually even preventing Alzheimer’s, he wrote in an accompanying editorial. 

The findings have no practical implications yet. 

First treatment

More than 6 million Americans, and millions more worldwide, have Alzheimer’s, the most common form of dementia. There’s no cure. But last year, a drug named Leqembi became the first to be approved, with clear evidence that it could slow the worsening of early Alzheimer’s — albeit for a few months. 

It works by clearing away some of that gunky amyloid protein. The approach also is being tested to see if it’s possible to delay Alzheimer’s onset if high-risk people are treated before symptoms appear. Still, other drugs are being developed to target tau. 

Tracking silent brain changes is key for such research. Scientists already knew that in rare, inherited forms of Alzheimer’s that strike younger people, a toxic form of amyloid starts accumulating about two decades ahead of symptoms, and at some point later, tau kicks in. 

The new findings show the order in which such biomarker changes occurred with more common old-age Alzheimer’s. 

Researchers with Beijing’s Innovation Center for Neurological Disorders compared 648 people eventually diagnosed with Alzheimer’s and an equal number who remained healthy. The amyloid finding in future Alzheimer’s patients was the first, 18 years or 14 years prior to diagnosis depending on the test used. 

Differences in tau were detected next, followed by a marker of trouble in how neurons communicate. A few years after that, differences in brain shrinkage and cognitive test scores between the two groups became apparent, the study found. 

“The more we know about viable Alzheimer’s treatment targets and when to address them, the better and faster we will be able to develop new therapies and preventions,” said Claire Sexton, the Alzheimer’s Association’s senior director of scientific programs. She noted that blood tests are coming soon that promise to also help by making it easier to track amyloid and tau. 
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Zimbabwe has launched an emergency polio vaccination campaign to contain a new outbreak, even as it fights a cholera outbreak that has claimed close to 500 lives. Columbus Mavhunga reports from Harare. Camera: Blessing Chigwenhembe.
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