infertility treatment

hanajohn · Post by **hanajohn** » Mon Sep 28, 2009 4:21 pm

Hi all!

My husband and I are trying to have a baby for a year. We went to the Turku university hospital for our first visit. Our doctor said that I'm not eligible for the infertility treatment from public hospitals because I'm a Hepatitis B carrier. My husband isn't a carrier. My question is that does my husband have the right to get a treatment? I mean it takes two people to have a baby.
We asked our doctor about this, but she was reluctant to answer it, just repeating there's nothing she can do for us:(

Any responses would be very much appreciated! Thanks+++

**Sponsor:**

biscayne · Post by **biscayne** » Tue Sep 29, 2009 12:34 pm

If you are the one who is infertile as a result of a genetic disorder, a physicial problem like blocked overies etc., but your husband's sperm count and motility is normal, then there is nothing to treat in him. What they would be doing is injecting his sperm into you (icsi - intercyclasmic sperm injection) or extracting an "egg" from you and "fertilising" it with his sperm, which means they would inject his sperm into your egg with a tiny needle and then "plant" the embryo into your uterus (womb). So they could get his sperm, but there is noone to inject it into, if they won't treat you.

If your husband is the one who is infertile (something wrong with his sperm, or some other physical problem, or a genetic issue) then it goes like this: if it's genetic, they can't do anything anyway, no gene therapy is available currently for male infertility. If there is something wrong with his sperm count, there is usually not much to be done about that either, physical issues can sometimes be helped, but again, it takes two, so who would they be "putting" his sperm into?

In the end, science & technology notwithstanding, it is still the female who has to become pregnant (that "bloke" in the USA still had a uterus), so if they won't treat you, it actually doesn't matter what they do to your husband, or whether is wildly fertile or totally infertile, because it seems they won't put his sperm into your uterus. I'm sorry for your problem. The only thing I can tell you is that a pos. Hep. B test is usually grounds for refusal of IVF treatment everywhere in Europe. I've worked in the area of Genetics, including IVF and infertility for a long time, and there is a battery of tests which are run before "allowing" treatment, testing for Hiv, syphallis, Hep. B + C, and some others, and if any of them come up positive treatment is refused.

biscayne · Post by **biscayne** » Tue Sep 29, 2009 12:38 pm

By the way, judging by your posting, it seems the doctor did not explain anything, not the basics of infertility, IVF, nothing - that is professionally irresponsible and I think you would have grounds to complain. Infertility is a terribly sad and depressing issue for so many couples and you have the right to as much information as possible, including test results, WRITTEN explaination of why you are not entitled to treatment, and of what treatments could work for you, so that you can seek them elsewhere if they are available to Hep.B carriers in someother facility/country etc.

mikkolover · Post by **mikkolover** » Tue Sep 29, 2009 2:33 pm

Hi, why don't you go to a clinic like Vaeseliito? They specialize in infertility, when OYS in Oulu wouldn't help us, because according to them I was 'too fat' to be pregnant, even though we had been trying for 8 years, we contacted Vaseteliito and they were wonderful! I am in no way so large that I couldn't carry a baby or have IVF, and it turned out my husband's sperm was so 'bad' that we had to do ICSI ( micro-injection) to fertilize my eggs. Years ahead and we have a gorgeous son.

Just a warning though, it is expensive. It is time consuming, it IS heartbreaking when things don't work out and IVF didn't work 3 times for us, so you have to think before hand exactly how far you want to go, and lastly, if you have been trying less than one year, you aren't considered infertile, unless you are over 35.

Good luck!

Tiwaz · Post by **Tiwaz** » Wed Sep 30, 2009 8:56 am

mikkolover wrote:Hi, why don't you go to a clinic like Vaeseliito? They specialize in infertility, when OYS in Oulu wouldn't help us, because according to them I was 'too fat' to be pregnant, even though we had been trying for 8 years, we contacted Vaseteliito and they were wonderful! I am in no way so large that I couldn't carry a baby or have IVF, and it turned out my husband's sperm was so 'bad' that we had to do ICSI ( micro-injection) to fertilize my eggs. Years ahead and we have a gorgeous son.

Just a warning though, it is expensive. It is time consuming, it IS heartbreaking when things don't work out and IVF didn't work 3 times for us, so you have to think before hand exactly how far you want to go, and lastly, if you have been trying less than one year, you aren't considered infertile, unless you are over 35.

Good luck!

Except you failed to notice something about original post.

HEPATITIS B CARRIER.

Something from wikipedia:

Prognosis

Hepatitis B virus infection may either be acute (self-limiting) or chronic (long-standing). Persons with self-limiting infection clear the infection spontaneously within weeks to months.

Children are less likely than adults to clear the infection. More than 95% of people who become infected as adults or older children will stage a full recovery and develop protective immunity to the virus. However, this drops to 30% for younger children, and only 5% of newborns that acquire the infection from their mother at birth will clear the infection[40]. This population has a 40% lifetime risk of death from cirrhosis or hepatocellular carcinoma. [37] Of those infected between the age of one to six, 70% will clear the infection.[41]

And little more

Transmission

Transmission of hepatitis B virus results from exposure to infectious blood or body fluids containing blood. Possible forms of transmission include (but are not limited to) unprotected sexual contact, blood transfusions, re-use of contaminated needles & syringes, and vertical transmission from mother to child during childbirth. Without intervention, a mother who is positive for HBsAg confers a 20% risk of passing the infection to her offspring at the time of birth. This risk is as high as 90% if the mother is also positive for HBeAg. HBV can be transmitted between family members within households, possibly by contact of nonintact skin or mucous membrane with secretions or saliva containing HBV.[23][24] However, at least 30% of reported hepatitis B among adults cannot be associated with an identifiable risk factor.[25

So, what we have here is case where huge amount of money, time and resources would be used to treat infertility in case where mother is hepatitis B carrier.

This in turn presents large risk that during childbirth, mother would transmit the disease to child, who in turn has very low chance of succeeding to fight off the contamination. Resulting in very high likelihood that child will die from conditions resulting from infection.

Sorry hanajohn, but it just does not make sense to waste all those resources for case where risks are just so damn big. Specially since there are couples lining up for treatment who do not have such conditions.

As they suggested here, you could try to go through private services. They hardly have issue with wasted money and time, because you pay for every minute fully. But then I would ask if you want to risk it? Dangers of your hepatitis B to your child do not go away no matter what.

biscayne · Post by **biscayne** » Wed Sep 30, 2009 11:14 am

Yes, Tiwaz is absolutely right. To be honest, I think that even a private place in Finland will not help you, because Finland is very "ethical" when it comes to these things and won't be trying to make money off. There are private clinics in Spain, which will do almost anything including sex selection of embryos, and there is a good private place in Brno, Czech Republic. But even if some clinic will treat you, do you really want to put a child through this? Obviously, that is of course, your choice, if you find a private place to treat you.

inkku · Post by **inkku** » Wed Sep 30, 2009 12:21 pm

Tiwaz is not absolutely right (though the end result might be the same). The ethics of health care and the right for certain treatment is not determined by rationality or cost-efficiency.

That Wikipedia does not contain information about the use of prevention of transmission, see eg:
http://www.informahealthcare.com/doi/pd ... ookieSet=1
http://www.ivf-basel.ch/fileadmin/bilde ... B_HepC.pdf

I believe contacting VÄESTÖLIITTO, as suggested above is a good idea, at least as a starting point.

Tiwaz · Post by **Tiwaz** » Wed Sep 30, 2009 1:23 pm

Your first link came up dead.

Second link does not speak anything of dangers of Hepatitis B.

What they mention is use of for example interferon to "treat" the disease, however further digging reveals something nasty:

How Effective is Interferon?:

* Response is usually assessed by loss of hepatitis B e antigen and hepatitis B virus DNA, detection of hepatitis B e antibody, and normalization of liver enzymes. Approximately 20-30% of patients will respond after a course of interferon therapy. Most responders (90%) maintain their response during long-term follow-up. Responders have a decreased risk of developing liver failure and liver cancer.

It apparently fails to work in large majority of patients. It is questionable how well it would work in case of OP.

Second thing they fail to mention is that vaccines take time to work. Vaccine is not from injection to immunity in an instant. They take TIME. As I have pointed out earlier, infection by Hepatitis B is very common during CHILDBIRTH. Newborn gets contaminated by mothers body fluids which contain Hepatitis B. At this point, vaccination is very questionable in it's functionality as vaccinations depend on introducing weakened bacteria/virus to immune system to prompt reaction when infected.

But should child be infected during childbirth, it is pointless. Vaccination does not have huge benefits if you vaccinate person AFTER they are infected. It's same as closing the barn doors after they have been open for a week.

And treatment is ruled by rationality. As we have seen, OP already has been denied fertility treatment because she is Hep B carrier. There just is no justification to use resources to treat someone with disease which has high likelihood to infect the child.

As said, they can try to get there through private clinics, but I find it unlikely that KELA would pay for anything for Hep B positive couple.

mikkolover · Post by **mikkolover** » Wed Sep 30, 2009 1:56 pm

I have no clue why this TIWAZ person is so argumentative, but I assume there is some pent up hostility there, and these boards are used for support, so perhaps you can look into creating a more thoughtful mail to the people here.

Also, I DID read the mail, i DID read the HEP B part and I DO understand the situation and I DO belive that Vaesteliito can at least answers questions if not help fully. What is it your business what this couple does with their body? I think that they can and should explore any option they have to create a family and there are NO other people more important. Trust me, everyone is as important. Even if you don't believe they are!

inkku · Post by **inkku** » Wed Sep 30, 2009 2:14 pm

I also dislike the belligerent style of Tiwaz. This can be a very delicate matter to some people, so i would suggest refraining from useless aggression.

For some reason, i would trust more on medical sources than wikipedia, however, admittedly we are all laymen to some exptent so OP should really contact experts in this case.

I am using a uni proxy, it is possible the access to that source is limited. it is a journal called Human Fertility.

HIV, hepatitis B and hepatitis C and infertility: reducing risk
Educational Bulletin sponsored by the Practice and Policy Committee of the
British Fertility Society: Carole Gilling-Smith and Paula Almeida
Assisted Conception Unit, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

they say " Infection in the neonate can be minimized if immunoprophylaxis (HBV vaccination and one dose of hepatitis B immunoglobulins) is given within 24 h of birth with a further dose at one and six months. These measures are reported to be 8595% effective in preventing HBV infection and the chronic carrier state. Breastfeeding does not appear to play a role in perinatal transmission (Centers for Disease Control, 1991)."

KELA benefits are a different case than the right to fertility treatment.

mikkolover · Post by **mikkolover** » Wed Sep 30, 2009 2:19 pm

NIcely put, and no KELA does not, nor does private insurance ( we have pohjola ) pay for any kind of fertility treatment. It is expensive, and a long, painful process that some of us go through to get the family of our dreams. Obviously it isn't something taken lightly, in the case of Hep B or not as it involves so much from the couple involved.

Tiwaz · Post by **Tiwaz** » Wed Sep 30, 2009 2:41 pm

You people clearly have little grasp of what actually goes on.
So you two really should be quiet.

http://www.vaestoliitto.fi/in_english/i ... ty/prices/

Our price list is only a guideline, because the number of appointments and examinations needed varies according to individual needs. These prices are applicable to patients with Finnish social security number. The fees vary somewhat from one Family Federation clinic to another.

Now, if you two could read Finnish you would go to their Finnish website where they state that they are involved with KELA direct payment system where patients ONLY need to pay for their omavastuuosuus. Not sure what it is in English, it is however part of cost which is paid by you which is small portion of TOTAL costs. KELA pays the REST.

Generally, KELA pays three fertility treatments up to 43 years of age.

As for sources, I would recommend you people to read sources. Wikipedia is reasonably reliable but if you feel like you want another sources feel free to. They all state the SAME GODDAMN THING.

Why? Because Hep B does not change it's nature anywhere. I have read same text from multitude of sources when I checked facts to shoot down crap some people try to feed OP. Just google it up.

And right for fertility treatment tends to end where KELA wants it to end. University hospitals refuse treatment for anyone with Hep B, C or HIV. It is highly unlikely that KELA would be making any payments either.

There are too much risks involved. Whining that some people somewhere think they can "minimize" risk of infecting born child is irrelevant.

Finland has so much couples looking for fertility treatment without ANY of mentioned diseases that resources are readily used by trying to treat them. And in those cases there is 0 chance of baby being infected by Hep C, Hep B or HIV since mother is not carrier.

inkku · Post by **inkku** » Wed Sep 30, 2009 3:23 pm

Vaestoliiton lapsettomuusklinikat provide information and counseling regarding infertility.

Turku Clinic
Maariankatu 3 A, 2. floor, 20100 Turku
Tel 358 2 212 0800
Fax 358 2 212 0850
turku.clinic@vaestoliitto.fi

Tiwaz, apparently discretion is not a virtue to you. Potentially you could also benefit from some counseling, i don't see any reason why you need to hurt the OP, she has merely asked advice. You yourself have introduced the rhetoric of kela benefits.

mikkolover · Post by **mikkolover** » Wed Sep 30, 2009 7:03 pm

Ha ha.. talk about someone who has no clue. Having been through 3 infertility treatments at Vaesteliitto ( great you have so much time to do your research

I know that KELA can and does pay some part of the treatment. It is a very small portion BUT if you do not have any KELA insurance, then you may pay for the whole treatment yourself.

Oh and wikipedia being reliable.. i just wrote on a page that the pope was really mickey mouse in a former life, and guess what, it was there for MANY hours before it was changed, so people can pretty much say what they want there without reference checks or the like.

Now, lets address the complete lack of respect and utter ignorance and rudeness. I have sent a message to the moderators of this board to get you TIWAZ kicked off these boards. You are an ugly, evil person without anything better to do than harass people. So, hopefully you can disappear for a while you miserable person!

Tiwaz · Post by **Tiwaz** » Thu Oct 01, 2009 6:59 am

mikkolover wrote:Ha ha.. talk about someone who has no clue. Having been through 3 infertility treatments at Vaesteliitto ( great you have so much time to do your research I know that KELA can and does pay some part of the treatment. It is a very small portion BUT if you do not have any KELA insurance, then you may pay for the whole treatment yourself.

Name Finn or citizen who does not have KELA insurance. Not to mention that you said that you were in VL because you were DENIED fertility treatment in public side. Guess what, public healthcare and KELA go hand in hand. If you are not accepted to public, you will not see much KELA money either.

And again, I remind you that Väestöliitto also has to take into account ethical part of fertility treatment even if OP pays for it fully.

Oh and wikipedia being reliable.. i just wrote on a page that the pope was really mickey mouse in a former life, and guess what, it was there for MANY hours before it was changed, so people can pretty much say what they want there without reference checks or the like.

You mean you wrote irrelevant rubbish into irrelevant file which very few if any people ever check and it went through nicely?

Did you remember to add REFERENCE to your SOURCE.
Unsourced information is useless, sourced is valid. But I guess you never have bothered to learn such basic thing. Thankfully in my studies when doing my graduation works I was repeatedly told that nothing I wrote was valid unless I had proof in form of recorded measuring or valid sources.

Now, lets address the complete lack of respect and utter ignorance and rudeness. I have sent a message to the moderators of this board to get you TIWAZ kicked off these boards. You are an ugly, evil person without anything better to do than harass people. So, hopefully you can disappear for a while you miserable person!

Respect is to be earned, you have not earned any respect by trying to lie or avoid truth. I have stated the truth which OP was after.

She is not going to be viable for fertility treatment because of health risk involved due to her disease. End of case.

Only theoretical solution would be removal of one of her eggs, fertilizing it and then having someone else carry it to term. But that again would not be supported by state.
Or adoption.

I find it disturbing that you are so twisted person that you would support taking any supplement drug company would sell to you to fight extremely rare condition, but in next breath fully support endangering newborn by telling person who is carrier of highly infections and dangerous (to newborns) disease to forget the risk, which is far greater than risk from little too little folic acid in food.

I do hope OP understands that her pregnancy has very serious dangers to her child to be and acts according to it instead of listening to loonies who apparently care little about health of child as long as their desires are fulfilled.

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