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  • 22
    Apr
    2012
    5:15pm, EDT

    Doc solves mystery of Frida Kahlo's infertility

    Getty Images / Hulton Archive

    Renowned Mexican painter Frida Kahlo, shown with her husband, Diego Rivera, desperately wanted to have children but was never able to carry a pregnancy to term.

    By Rita Rubin

    When Dr. Fernando Antelo looks at “The Broken Column,” one of many self-portraits depicting artist Frida Kahlo’s chronic pain and health problems, he feels like he’s having a conversation with a colleague as well as a patient.

    The piece, painted shortly after Kahlo underwent spinal surgery at around age 37, shows the artist, who had taken pre-med courses in high school, encased in a body brace. The flesh down the middle of her neck, chest and abdomen is missing, exposing a broken column where her spine should be. Nails pierce her face and body as tears stream down her cheeks.

    “I see her as a patient wanting to tell me about her symptoms, and at the same time I see her advanced knowledge, her ability to tell me about it as another physician would,” Antelo says. “Seeing that painting made me want to ask more questions.”

    A surgical pathologist at the Harbor-UCLA Medical Center in Los Angeles, Antelo decided to investigate why Kahlo, who died in 1954 at age 47, suffered numerous miscarriages and underwent at least three therapeutic abortions.

    “I think it’s one of those things where we owe it to Frida,” says Antelo, noting that many of Kahlo’s paintings contain images related to reproduction and fertility, but only historians, not doctors, have delved into why the artist was unable to have a baby. Articles in the medical literature have focused on her chronic pain and orthopedic and neurological issues.

    Antelo’s conclusion, which he presented Sunday at the annual meeting of the American Association of Anatomists in San Diego, is that Kahlo suffered from a rare condition called Asherman’s syndrome.

    First described in 1894, Asherman’s syndrome occurs when the lining of the uterus, or endometrium, is damaged and scar tissue forms. In most cases today, it results from repeated dilatation and curettage (commonly known as D & C), a procedure used to clear out the uterine cavity after childbirth, miscarriage or abortion.

    Reed Saxon / AP

    A visitor views "Las Dos Fridas (The Two Fridas)," a 1939 oil on canvas painting by Frida Kahlo at the Los Angeles County Museum of Art on Feb. 1, 2012.

    Today, doctors treat the condition by peering into the uterus with a special magnifying camera on the end of a tube and carefully removing the scar tissue. But even if Kahlo had been diagnosed, Antelo says, “with the technology that they had then, they really couldn’t treat it.”

    Kahlo’s condition originated with a streetcar accident when she was a teenager, according to the surgical pathologist. A metal handrail penetrated her abdomen, severely damaging the skeletal framework and internal organs, including her uterus. Among other things, the accident dashed her dream of attending medical school.

    “She kept attempting to have children with a uterus that wasn’t in any condition to do that,” he says, and the resulting therapeutic abortions and miscarriages likely exacerbated her Asherman’s syndrome.

    While numerous historians have offered reasons for Kahlo’s infertility, none of them have connected it to the streetcar accident, Antelo writes in his abstract.

    Some colleagues have suggested that Kahlo’s inability to carry a pregnancy to term stemmed from a problem with the fetus or maybe a blood disorder, he says.

     “There could be other contributing factors,” Antelo acknowledges, “but in my mind, this has got to be a key thing. We have major injury to the uterus.”

    What other medical mysteries of the past would you like to see today's doctor's solve? Tell us on Facebook.

    Correction: An earlier version of this story cited the wrong year for Frida Kahlo's death. It has been updated with the accurate year.

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    65 comments

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  • 20
    Jan
    2012
    8:40am, EST

    'Miracle' baby born from single frozen sperm

    Chris Langer / msnbc.com

    Jennifer and Jason Schiraldi, of Campbell, Ohio, struggled for two years to have a child, without success. A ground-breaking technique at Cleveland Clinic, however, led to the birth of their daughter, Kenley, 9 months.

    By JoNel Aleccia, Senior Writer, NBC News

    Everyone knows it takes just one sperm and one egg to make a baby, but nature usually provides extra, just to be sure.

    In the case of 9-month-old Kenley Schiraldi of Campbell, Ohio, however, there was no back-up for the biology, requiring instead what scientists -- and her parents -- are calling a modern-day miracle.

    Kenley was born last April, the result of a long-shot infertility treatment, a case Cleveland Clinic IVF experts say is the first time a single sperm has been frozen, injected into a single egg -- and resulted in a healthy pregnancy.

    “It was better than hitting the lottery,” said Jennifer Schiraldi, 33, Kenley’s mom. “This never happens.”

    Indeed, even Nina Desai, director of the IVF laboratory at the Cleveland Clinic, hasn’t calculated the odds of Kenley’s conception, which occurred even though her father, Jason, produced no sperm in the regular way, and her mom had trouble producing eggs.

    “It was like a shot in the dark,” said Desai, who has developed a ground-breaking technique that can find and store tiny amounts of sperm -- or even just one -- in a drop of fluid inside a straw as thin as a sewing needle. The sperm can then be frozen and later thawed for use in an in-vitro fertilization technique known as intracytoplasmic sperm injection, or ICSI.

    The new method follows nearly two decades of efforts to save the smallest possible amounts of human sperm by storing the cells inside hamster eggs or on tiny nylon loops for easier retrieval later. It’s expected to be a boon for men with very low sperm counts, a severe form of the male factor infertility that can contribute to the 1 in 8 couples in the U.S. who struggle to conceive.

    Jennifer Schiraldi, a hospital dietician, and her husband, Jason, 35, a cardiac catheterization nurse, came to the Cleveland Clinic in 2009, after trying for two years to get pregnant, with no success. High school sweethearts who’ve been married nine years, they were young and healthy with no warning that they’d have trouble having a baby.

    “I’d never had any woman problems and you never think it’s the guy,” recalled Jennifer.

    In fact, however, tests showed that the Schiraldis were among 30 percent to 40 percent of infertile couples with problems attributed to the man.

    “They took a sample and we found out immediately: There’s no sperm,” Jennifer Schiraldi recalls.

    The couple could have stopped there, but they decided to pursue aggressive infertility treatment, including a testicular biopsy, which involves surgery to remove tiny bits of tissue to test for evidence of sperm.

    The procedure was difficult, admits Jason Schiraldi, but he said he was determined to try everything.

    “We always wanted kids and I didn’t want to be the one who couldn’t do that for her,” he said.

    But searching for Jason’s sperm proved even harder than imagined. As the surgeon sent down samples, Desai’s lab staffers, three in all, used microscopes to scan the tissue for any sign of viable cells.

    A typical male produces 60 million to 100 million lively sperm in a single ejaculation.

    After searching Jason’s tissue for a total of nine hours, the scientists found -- one.

    “We froze that one sperm and we saved the rest of the specimens,” recalled Desai. “We really had no hope of it doing anything.”

    Because any pregnancy with so few sperm would require in-vitro fertilization, Jennifer Schiraldi had to harvest her eggs. But when they went to retrieve them, doctors found she made far fewer eggs than normal.

    “I got 12 but only eight were good,” she recalled.

    IVF experts searched the rest of Jason’s samples, hoping to fertilize as many of Jennifer’s eggs as possible. When they found only a couple dead sperm, the one frozen viable sperm was the only option.

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    “They got the one sperm and implanted the one egg,” Jennifer Schiraldi said.

    Desai admits she wasn’t optimistic.

    “People don’t usually get pregnant when they have only one egg,” she explained, noting that it’s far more common to implant two or three embryos to make sure pregnancy occurs.

    But then came the exciting part. With the help of a careful ICSI procedure, the egg was successfully fertilized. Three days later, it had divided into a viable embryo and was implanted in Jennifer’s womb.

    Sixteen days after that, she was confirmed pregnant.

    “It was very emotional,” said Jason Schiraldi.

    Back at the clinic, the staff shared congratulations.

    “I was really surprised when I saw she had a positive pregnancy,” said Desai. "This has been one of the real miracles in our IVF program."

    The pregnancy was normal but taxing, with a fair amount of nausea and other ordinary complications, Jennifer Schiraldi said. And the baby was in the breech position, which required a C-section.

    But when Kenley Karlin Schiraldi arrived on April 20, her parents said there was no doubt about what had occurred.

    “Miracle is not a large enough word to describe it,” said Jason Schiraldi. “Of all the fascinating and amazing things we do in the health care field, it’s amazing that this happened to us.”

    Jennifer Schiraldi says she looks at her daughter every day and marvels that she’s here.

    “It’s crazy. Sometimes I’m, like, ‘Did we cheat?’” she said. “People ask if we’re going to have another child, but we made it this far to get her. I don’t know if I even want to press my luck.”

    Desai and her colleagues plan to use the new sperm storage technique to help other patients with very low sperm counts. Next week, in fact, another man with the same problem is scheduled for the treatment.

    Jason Schiraldi said other couples should be encouraged by their experience.

    “People think once you’re stuck, you’re stuck,” he said. “But there are people who can make wonderful things happen.”

     

    Discuss this story on our TODAY Health Facebook page.

     

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  • 14
    Dec
    2011
    1:42pm, EST

    FDA cracks down on DIY sperm donor in Calif.

    The Food and Drug administration is working to put an end to a California' man's free sperm donation operation. Trent Arsenault, who has provided more than 350 donations and fathered 14 children through them, tells KNTV's Traci Grant he's just "helping people in need."

    By JoNel Aleccia, Senior Writer, NBC News

    A California man is vowing to continue his do-it-yourself sperm donor operation, despite efforts of federal health officials to crack down on the free service.

    Trent C. Arsenault, 36, of Fremont, Calif., told msnbc.com that he has fathered 14 children -- with four more on the way -- and donated sperm to between 60 and 75 families since he started the online operation in 2006.

    “Every time I log into Facebook, I’m overwhelmed with all the pictures from the families,” said Arsenault, who regards his donations as a way to help low-income people struggling with infertility.

    Last year, federal Food and Drug Administration officials delivered a letter ordering Arsenault to “cease manufacturing,” or halt his service, because the computer security expert had not followed regulations governing safety precautions for transmission of human cells or tissues through donor clinics.

    “We have legitimate concerns,” said Shelly Burgess, a spokeswoman for the FDA.

    But Arsenault was allowed to continue the operation while the agency decided whether to grant him a hearing on the matter, according to his lawyers.

    The lawyers, who work for the nonprofit legal firm Cause of Action in Washington, D.C., argue that Arsenault shouldn’t be held to clinic sperm donor standards because his contracts with recipients are individual intimate partner arrangements allowed under the law.

    No hearing has yet been scheduled, Burgess said. Arsenault could face penalties including court action if the agency concludes that his acts were a violation of federal regulations. 

    388 comments

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