How 'toxic' is sugar?

Emerging research suggests that sugar may be linked to deadly diseases, but Health Canada's current food labelling regulations make it tough for Canadians to get an easy picture of how much of the sweet substance they are consuming — and it doesn't look like that's going to change any time soon.

The groundbreaking and controversial research explored by the CBC's the fifth estate in its season premiere tonight links sugar to diseases ranging from diabetes to cancer and Alzheimer's.

"Sugar is toxic beyond its calories," Dr. Robert Lustig, an expert on childhood obesity at the University of California, San Francisco, told the fifth estate's Gillian Findlay.

Watch The Secrets of Sugar on the fifth estate on CBC-TV tonight at 9 p.m.

While Canadians have become used to warnings about the dangers of consuming too much fat or salt, nutrition labels on food have never included recommended daily limits specifically for sugar.

Health Canada does not have a recommended limit for how much sugar Canadians should consume in a day.

A representative of Food and Consumer Products of Canada, an industry organization that represents the largest food companies in the country, says it sees "no need" for a recommended daily limit on sugar intake.

Health Canada declined numerous requests by the fifth estate for an interview, but former Health Canada employees did speak off the record, and said the department does not think that sugar should be singled out as a major culprit behind chronic diseases.

Stirring up debate

According to Statistics Canada, the average Canadian consumes 26 teaspoons of sugar per day. That works out to 40 kilograms per year —– or 20 bags.

While neither the Canadian nor U.S. governments has a recommended daily limit for sugar consumption, one major U.S. medical group is recommending people cut back on the sweet substance.

The American Heart Association is suggesting men consume no more than nine teaspoons a day. For women, the recommendation is a maximum of six teaspoons.

Dr. Robert Lustig, as expert on childhood obesity at the University of California, San Francisco, says 'sugar is toxic beyond its calories.' (CBC)

That recommendation comes as research from a small but influential group of medical researchers is stirring up debate on the impact sugar has on health.

One of the most vocal of those researchers is Lustig, an author who has become a YouTube sensation for a 90-minute lecture in which he calls sugar a toxic poison.

"I use those words and I mean them. This is not hyperbole. This is the real deal," he told Findlay.

"Everyone thinks that the bad effects of sugar are because sugar has empty calories. What I'm saying is no, there are a lot of things that do have empty calories that are not necessarily poisonous."

Breaking down the sugar

Lustig says that sugar, which is made up of glucose and fructose molecules, is a poison because of the way our bodies break it down.

"When you metabolize fructose in excess, your liver has no choice but to turn that energy into liver fat and that liver fat causes all of the downstream metabolic diseases."

But not everyone agrees with Lustig's theory, including other doctors and food industry representatives.

Dr. John Sievenpiper, a researcher at St. Michael's Hospital in Toronto, questions Lustig's methodology and his view that "sugar and only sugar" is the prime factor in the international food supply that "predicts [the] diabetes rate worldwide."

Sievenpiper notes that during the same time period when Lustig points to increasing sugar consumption and rising rates of obesity —– something that has been linked to diabetes — there was also increasing consumption of bottled water.

'We have to be careful in putting too much of the biological plausibility in wanting to believe patterns that we see.'- Dr. John Sievenpiper

"But there's no real biological plausibility in the link between bottled water and [being] overweight and obesity. We have to be careful in putting too much of the biological plausibility in wanting to believe patterns that we see."  

Sievenpiper isn't recommending people eat a lot of sugar, but he does suggest we should be careful about saying fructose is largely responsible for various health problems.

"As long as you match for calories, fructose does not behave differently than does any other form of carbohydrate, namely starches or fine starches and glucose. And that's not to say that they're benign, because I don't think we should be having a lot of refined starch or glucose. But it's not behaving any differently."

Industry skepticism

A representative of Canada's largest food industry association is also skeptical of Lustig's research.

Phyllis Tanaka, vice-president of scientific and regulatory affairs for Food and Consumer Products of Canada, isn't worried about Lustig's claims about one of her industry's key ingredients and doesn't think consumers should be either.

Phyllis Tanaka, vice-president of scientific and regulatory affairs for Food and Consumer Products of Canada, says her group has worked with Health Canada over the last few years on how to help consumers make 'informed choices.' (CBC)

"I think it's important that we step back and look for ways to educate and help consumers fit sugar into a healthy dietary pattern," she said.

But current food labelling regulation can make it difficult for consumers who want to avoid sugar.

On Canadian nutrition labels, manufacturers are required to list ingredients in order from greatest to least volume. But many labels list multiple kinds of sweeteners with different names. For example, honey, barley malt syrup and evaporated cane juice could all be listed separately, even though the human body treats them all as sugar.

Also, sugar is measured in grams on labels, instead of more consumer-friendly teaspoons. For someone trying to keep track of intake, four grams of sugar equals one teaspoon.

In a can of Coke, for example, there are more than 10 teaspoons of sugar. The popular "Healthy Choice" microwave chicken dinner has 5½ teaspoons.

Tanaka says her group has worked with Health Canada over the last few years on how to help consumers make "informed choices," and that for those who want to avoid sugar, all the information they need is already on the label.

"At this point in time, I'm comfortable in saying the science just isn't there to support a role in chronic disease."

Watch The Secrets of Sugar on the fifth estate on CBC-TV tonight at 9 p.m.

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Do fans of losing teams drown sorrows in junk food?

NHL fans watch out: disappointed sports fans may be more likely to indulge in junk food the day after their team loses.

Yann Cornil and Pierre Chandon of the INSEAD Business School in Fontaineblue, France, analyzed two seasons of NFL games and people's food consumption.  

Fans of losing sports team may seek out more comfort food, researchers say. (CBC)

On Mondays following a Sunday game in the National Football League, the researchers found that people in cities with a losing football team ate about 16 per cent more saturated fat and 10 per cent more total calories compared to their usual Monday consumption.  
 
In contrast, people in cities with a winning football team ate about eight per cent less saturated fat and five per cent fewer total calories compared to their usual consumption.  
 
Eating patterns stayed at usual levels in cities without an NFL team or with a team that didn't play.
 
"Overall, what this shows is that we're much less under control over eating as we'd like to believe," Chadon said in an interview.
 
"The environment, broadly speaking, so who wins, who loses, how food marketing is in place where you live, influences a lot of our food decisions without us being aware of it necessarily."
 
Chandon said he was surprised to find the effects were greater in cities where the defeats were narrow, which suggests it's disappointment that influences unhealthy eating.  
 
These trends held even when people who weren't football fans were included in the sample.
 
The researchers also tested the associations in a series of experiments. They asked French participants to write about a time when their favourite team lost or won while they were offered chips, candy, grapes or tomatoes. Those whose team won tended to snack on the healthier options while those in the losing group chose more junk.  
 
The study, published in the journal Psychological Science, also pointed to a potential solution for fans of losing teams.  
 
"Just thinking about the other things that are out there in life that matters to you influences how much people eat and completely eliminated the effect of the defeat."
 
The CBC's Kim Brunhuber caught up with fans of winning and losing NHL teams to find out whether their diet patterns changed after their favourite teams faced off. 

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Breast cancer risk lowered by walking 1 hour a day

Walking at least one hour a day may lower the risk of breast cancer in postmenopausal woman, a large, long-term study suggests.

Previous studies have suggested that women who get physical activity regularly have a 25 per cent lower risk of breast cancer compared to those who were the most inactive. Now researchers have looked at the question in more detail, focusing on whether walking helps in the absence of more vigorous exercise.

Epidemiologist Alpa Patel of the American Cancer Society and her co-authors compared exercise levels for 73,615 postmenopausal women, including 4,760 who were diagnosed with breast cancer over 17 years.

"Women who engage in an at least seven hours of walking over the course of a week may reap a modest benefit, even in the absence of more vigorous exercise," Patel and her co-authors concluded in Thursday's online issue of the journal Cancer Epidemiology, Biomarkers and Prevention.

"Given that breast cancer is the most common cancer affecting women, and that walking is a common activity among postmenopausal women, the finding of a possible lower risk with an average one or more hours/day of walking is of considerable public health interest."

Those who walked at a leisurely pace of 4.8 km/h for an hour a day reduced their breast cancer risk by 14 per cent, which translates to about one fewer woman in 1,000 getting breast cancer each year, Patel said.

Walking more vigorously at a pace of  7.2 km/h for one hour a day reduced the risk by 25 per cent compared with those who were least active, meaning 1.6 cases of breast cancer per 1,000 would be avoided per year.

"Physical activity may act favourably on hormonal and non-hormonal pathways to lower breast cancer risk," such as weight control, the study's authors said.

The association between physical activity and breast cancer did not differ based on tumour factors like hormone receptor status, body mass index or the use of postmenopausal hormones, which the authors said were unclear until now.

Unlike two other studies that suggested sitting time may increase breast cancer risk, Patel's team did not find any evidence of that. The authors noted that most of the women in the study were homemakers with an average age of 63 when the study began, so the findings may not reflect total physical activity of those whose occupations involve manual activity.

The researchers conducted a careful study with followup every two years, said Christine Friedenreich, an epidemiologist at Alberta Health Services Cancer Care. Her own review of more than 70 studies found similar benefits for physical activity and breast cancer.

Current guidelines recommend that Canadian adults get at least 2.5 hours per week of moderate to intense activity, but fewer than half get that, according to the Canadian Health Measures Survey.

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Ottawa willing to talk assisted suicide, but won't legalize it

Health Minister Rona Ambrose says she's willing to talk to her provincial and territorial counterparts about assisted suicide when she meets with them Friday, but insists Ottawa has no intention of legalizing it.

"I will take part in the conversation," she said Thursday. "It's an important conversation to have, and of course all of us have had these conversations around the kitchen table."

Several health ministers gathered for a conference in Toronto said there should be a national discussion about the emotionally-charged subject, but wouldn't say whether assisted suicide should be legalized.

"What I can say collectively is that there are many standing here that are torn on this matter and believe that this is a conversation whose time has come," said Manitoba Health Minister Theresa Oswald.

"That doesn't mean that they are fors or againsts. I think that there are people standing here — and certainly in my province — that believe we should be having a national conversation about this."

Health Minister Rona Ambrose says she is willing to discuss assisted suicide when she meets with her provincial and territorial counterparts on Friday. (Andrew Vaughan/Canadian Press)

Manitoba doesn't have a position on whether assisted suicide should be legalized. But the conversation about it must be "entrenched in compassion," she said.

The ministers were briefed by Quebec's health minister about his government's right-to-die legislation, the first of its kind in Canada. If passed, it would outline the conditions necessary for someone to get medical assistance to die.

"They were very interested of what's going on in Quebec and very interested in following ... the evolution of this bill," said Quebec Health Minister Rejean Hebert.

Hebert's presentation was interesting in how Quebec has addressed the issue, putting it in very specific medical terms and developing criteria, he said.

Like many provinces, Alberta doesn't have a firm position yet on assisted suicide, said Fred Horne, the province's health minister.

"Canadians are already talking about this," Horne said. "They expect their elected officials to be listening and following the discussion."

Assisted suicide has been debated for decades, but the taboo topic resurfaced recently after a prominent doctor made an impassioned, videotaped appeal to legalize it just a few days before his death.

Eight days before he died from a brain tumour at age 68, Dr. Donald Low, who guided Toronto through the 2003 SARS crisis, asked that Canada allow people to die with dignity.

Ontario Health Minister Deb Matthews said Low would be "tickled pink" that he succeeded in renewing the debate.

"I think that this is a conversation that people need to have," she said. "I don't think it's a government decision right now."

The Canadian health ministers are scheduled to continue their conference Friday in Toronto, where the provinces will likely press Ambrose to reverse funding cuts to health care services to refugees, among other things.

In their communique, the ministers said they had "serious concern" about the cuts, which could cost them millions of dollars.

"Some vulnerable patients in need of care have found it difficult to access adequate treatment while hospitals and other health-care providers have assumed costs that had previously been borne by the federal government," the communique said.

Ambrose said the decision to change the benefits was based on fairness, "that refugees were receiving benefits that no other Canadian receives — taxpaying Canadian."

She said she will speak to the provinces about what benefits refugees can still access and ask them to keep track of any additional costs that they're incurring.

"Canada is a very compassionate country, and those that need emergency care are not going to go without it," Ambrose added.

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Twin births by C-section no safer than vaginally

Jessica Kudlats gave birth to twins Jordyn and Coby Sargon by C-section three years ago. (Courtesy Jessica Kudlats)

Giving birth to twins vaginally is equally safe for both the babies and mothers compared with caesarean section deliveries, according to a large, Canadian-led study.

The Twin Birth Study published in Wednesday's online issue of the New England Journal of Medicine is a 10-year trial that randomly assigned 2,800 women, including 260 in Canada, to either vaginal or caesarean births for twins in uncomplicated pregnancies.

"There does not seem  to be any advantage to the baby by doing a planned caesarean section," said Dr. Jon Barrett, the study's principal investigator and chief of maternal-fetal medicine at Toronto's Sunnybrook Health Sciences Centre.

"To be honest, that's why most women and practitioners were tending to chose caesarean section  because they thought that caesearean section was safer," he said. 

The study was designed to look for differences in deaths and severe complications among the babies, such as brain or spinal cord injury. Deaths and major complications in the mothers, such as need for hysterectomy and major blood loss, were also tracked.

The researchers found 60 deaths or major complications among infants in the planned C-section group, 2.2 per cent, compared with 52 or 1.9 per cent in the planned vaginal group. Statistically, that amounts to no difference, meaning planned C-sections aren't safer or riskier than planned vaginal births.

To be eligible for the study, the pregnancies needed to be uncomplicated, with the first twin in cephalic or head-first position, the pregnancy was between 32 weeks and 38 weeks and six days of gestation, and both fetuses alive with an estimated weight of between 1,500 grams and 4,000 grams based on ultrasound estimates a week before the randomization.

Currently in Canada, between 60 and 80 per cent of twins are delivered by C-section. Barrett hopes the findings will reverse reliance on C-sections. That will require obstetricians to preserve their skills in performing vaginal deliveries of twins, he said.

Of the planned C-sections, 90 percent ended up being C-sections. Of the planned vaginal deliveries, 56 percent were vaginal for both twins. 

Dr. Michael Greene of the department of obstetrics and gynecology at Massachusetts General Hospital in Boston applauded the massive logistical effort it took to conduct the trial.

"Obstetricians exercising their best clinical judgment delivered both twins by caesarean section in nearly 40 per cent of the women assigned to planned vaginal delivery, which undoubtedly contributed to the salutary outcomes," Greene said in a journal commentary accompanying the study.

"However, the results of this study suggest that a plan to deliver appropriately selected sets of twins vaginally is a reasonably safe choice in skilled hands."

Twins still need to be delivered by C-section in some circumstances, such as if the first twin is in a breach position or the babies are very premature, Barrett said.

Jessica Kudlats, 37, of Toronto, was eligible to birth to her twins vaginally three years ago. She chose C-section. After speaking with friends who had vaginal births for single babies, she now regrets the decision.

"I never experienced the birthing process," Kudlats said.

Kudlats said other friends who gave birth to twins planned for C-sections. "A lot of people, it's the fear of the unknown," she said of their motivation. "They want everything lined up."

Kudlats said she was in a lot of pain and unable to move to care for her son, Coby, and daughter, Jordyn, shortly after the births.

The study was funded by the Canadian Institutes of Health Research.

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90-year-old gets apology for 2 a.m. hospital discharge

Fraser Health has apologized for sending a 90-year-old blind woman home in the middle of the night in a taxi, wrapped in a bed sheet, dressed in pyjamas and slippers, and bleeding from blood tests.

"This is a very unfortunate incident and Fraser Health has apologized to the family for any inconvenience and distress this may have caused," said a statement issued by spokeswoman Tasleem Juma.

"Out of respect for patient confidentiality, we cannot discuss the details of the case, but we can reassure the family and the public that we are taking this very seriously." 

Vivian Fitzpatrick, who is legally blind, was taken to Delta Hospital by an ambulance at 10:30 p.m. PT Tuesday night after she felt an intense pain in her leg, which turned out to be a case of high blood pressure.

After she was cleared by a doctor, an unknown nurse came into her room and told her she was going home, Fitzpatrick said.

"The nurse came in and said 'the doctor says you can go home, there's nothing wrong with you'," she told CBC News.

Despite Fitzpatrick pointing out she wasn't dressed, the nurse told her they had ordered her a taxi and were sending her home.

"I was kind of stunned," she said.

The unknown nurse then wrapped her in a single sheet, gave her socks for her bare feet, and moved her into the emergency waiting room until the taxi arrived nearly an hour later at 2:30 a.m. PT.

When the taxi arrived, the driver walked her across the parking lot in a wheelchair in the pouring rain and wind, she says.

After arriving at home, Fitzpatrick was greeted by her live-in caregiver, who noticed that her arm was bleeding considerably from her earlier blood tests.

"She took off my jacket, and my jacket was soaked right through with blood... not my jacket, my pyjamas top and the sheet around me was soaked in blood," Fitzpatrick said.

Fitzpatrick's daughter, Paddy Munro, is disturbed by the incident.

"How can that happen? A 90-year-old woman sent out in the pouring rain in pyjamas and shivering in a waiting room by herself," she said.

"How can that happen?"

Fraser Health said in a written statement that they cannot comment on the specifics of the case, but that sometimes patients are sent home by taxi and they ensure patients are met by a caregiver when they arrive home.

"We are working with the family through the Patient Care and Quality Office to ensure this type of situation does not occur again," the statement said.

Fitzpatrick is still shaken by her experience.

"I don't want to go to that hospital again, I'm so upset," she said.

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Babies with flat heads treated in record numbers

Medical experts in the Maritimes say they are shocked by the number of babies with flat or misshapen areas of their heads, a condition called plagiocephaly that can be caused by them spending too much time on their backs.

Physiotherapists at the IWK Health Centre in Halifax now see 10 to 20 referrals a month for babies with plagiocephaly.

"It can happen to anyone," said Krista Sweet, a physiotherapist. "And most of the time, it happens before you even notice it."

Social worker Maura Donovan of the IWK Health Centre in Halifax says half the babies she works with have misshapen heads. (CBC)

While the distortions are cosmetic and rarely cause a medical problem, left untreated, they can become permanent and affect the child later in life.

Sweet said the problem can be caused by a long list of factors, but generally the babies are spending too much time in the same position.

"Especially if you rest your head back against something that's fairly solid, so, car seats that are used for something besides just being in a car, or too much time in a bouncy chair."

Babies are most vulnerable as newborns, but the shape of their heads can change up to their first birthday.

Maura Donovan, an IWK social worker who does home visits, is shocked by the number of plagiocephaly cases she sees.

"I'd say about half of the families in our program have a child with a flat spot or a head-turning preference. At least half," she said.

"We are seeing a very high number of babies in our program who have either a flat spot on their head, or a preference of turning just to one side and really, very limited movement and ability to turn to the other side."

Donovan said parents don't realize that long hours spent in unnatural positions can slowly deform a baby's skull.

"They're not given any education or information. They have no idea that their child's at risk of this."

The numbers at the IWK are in line with a recent study conducted in Calgary — the first of its kind — that indicated 46 per cent of the heads of babies in Canada are misshapen.

Sweet said it's important for parents to work with their babies as soon as they spot the condition.

"It's a fair bit of work because you need to get the child repositioned frequently."

She suggests parents ensure their children spend time on their stomach when they're awake. It also helps when parents hold babies facing them or carry them in a sling.

Sweet stressed it is still important for children to sleep on their backs to help prevent sudden infant death syndrome (SIDS).

"But when they're awake, and you're in the room and monitoring what they're doing and playing with them, it's really important to get them on their belly," she said. "Not just for their head shape, but also for their overall development."

The IWK Health Centre says new parents looking for more information can talk to a public health nurse or their family doctors.

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Pharmasave ibuprofen, Remedy's Rx cold capsules recalled

Vita Health's recall of products for labelling issues is expanding to include more cold and pain products.

Health Canada said it's been informed by Winnipeg-based Vita Health that the latest products being recalled are Remedy's Rx Cold + Sinus and Pharmasave Extra Strength Ibuprofen Liquid Capsules 400 mg.

"A labelling error incorrectly states the product is packaged with a child-resistant bottle and cap," the regulator said.

The products were distributed nationally at the retail level.

Canadians can check for details on this and similar recalls on the Healthy Canadians website. 

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25,000 a year left hospital despite doctor's order

Dr. Stephen Hwang of St.Michael's Hospital in Toronto says it is important to be proactive in ensuring followup for patients who leave against medical advice. (The Canadian Press)

People who leave hospital against medical advice are more than twice as likely to be readmitted within a month compared with patients who are discharged as scheduled, a new Canadian report shows.

Patients who leave hospital earlier than their health team recommends are known to be at increased risk of harm, including readmission to hospital and death, according to previous studies.

Tuesday's report from the Canadian Institute for Health Information paints a profile of the characteristics of people who are more likely to leave hospital against medical advice and quantifies readmission rates.

In 2011-2012, a total of 25,137 admission or 1.3 per cent of acute hospital admissions ended with patients leaving against medical advice across the country, excluding Quebec.

Compared with patients with routine discharges, those who left early were:

• More than twice as likely to be readmitted within a month (24 per cent versus nine per cent).
• More than three times as likely to visit emergency within a week (35 per cent versus 11 per cent.)
• Had an average of 2.3 inpatient admissions per year compared with 1.3 for other patients.

Self-discharged patients were more likely to be younger and male, and a have a history of leaving against medical advice, CIHI said. They were also more likely to have mental health issues and diagnoses of psychoactive substance abuse.

"The current study found that patients were more likely to leave against medical advice between evening and early morning hours," the report's authors concluded.

"It is telling that patients who leave against medical advice are also more likely to live in low-income neighbourhoods; they likely have more restricted options for child care and less flexibility in their places of employment."

Dr. Stephen Hwang, a scientist and physician at St. Michael's Hospital in Toronto, speculated on one factor: At night, the team that regularly looks after a patient and has a good understanding of patient issues aren't available, which emphasizes the importance of improving handover instructions for all patients.

"It's very frustrating when a patient wants and insists on leaving when we think it's inadvisable," Hwang said. "I always try to understand the situation from the patient's perspective."

Sometimes, after having an open and honest conversation to understand why the patient wants to leave, he or she will reconsider, Hwang said, adding the majority don't change their mind.

In those cases, Hwang said, it's important to be more proactive in ensuring followup, such as having the patient leave with antibiotics in hand or calling in a couple of days with the aim of giving the patient the best chance of staying out of hospital.

In a second part of the report, the institute's authors said nearly one per cent of discharges — almost 53,000 people — left against medical advice from emergency departments in Alberta and Ontario. The rates are comparable to those in other countries, they said.

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Infertile woman gives birth after ovary treatment in Japan

In this Dec. 28, 2012 photo provided by Dr. Kazuhiro Kawamura of the St. Marianna University School of Medicine in Kawasaki, Japan, Kawamura holds a newborn baby whose 30-year-old mother was treated for primary ovarian insufficiency. (Kazuhiro Kawamura/Associated Press)

A 30-year-old infertile woman gave birth after surgeons removed her ovaries and re-implanted tissue they treated in a lab, researchers report.

The experimental technique was only tried in a small group of Japanese women with a specific kind of infertility problem, but scientists hope it can also help women in their early 40s who have trouble getting pregnant because of their age.

The new mother gave birth to a son in Tokyo last December, and she and the child continue to be healthy, said Dr. Kazuhiro Kawamura of the St. Marianna University School of Medicine in Kawasaki, Japan. He and others describe the technique in a report published online Monday by the Proceedings of the National Academy of Sciences.

The mother, who was not identified, had been diagnosed with primary ovarian insufficiency, an uncommon form of infertility sometimes called premature menopause. It appears in about 1 percent of women of childbearing age. The cause of most cases is unknown, but the outcome is that the ovary has trouble producing eggs.

That leaves women with only a 5 per cent to 10 per cent chance of having a baby unless they get treated. The standard treatment is using donor eggs.

After the experimental procedure, Kawamura and colleagues were able to recover eggs from five of their 27 patients. One woman went on to have a miscarriage, one did not get pregnant, and two more have not yet attempted pregnancy, Kawamura said in an email.

The approach differs from what has been done to preserve fertility in some cancer patients, who had normal ovarian tissue removed and stored while they underwent cancer treatments, and then put back. The new work involved ovaries that were failing to function normally.

In the ovary, eggs mature in structures called follicles. For women with the condition the new study targeted, the follicles are either missing or failing to produce eggs. The experimental treatment was designed to stimulate dormant follicles.

First, the women's ovaries were removed and cut into strips, which were frozen. Later the strips were thawed and cut into tiny cubes, a step intended to stimulate maturation of the follicles. Then the cubes were treated with drugs to stimulate further development of the follicles. Cubes were then transplanted just under the surface of the women's fallopian tubes.

Within six months, eight women showed signs of follicle maturation, and five of them produced eggs for fertilization in the lab with their husbands' sperm. The fertilized eggs were grown into early embryos, which were frozen for preservation. In the three attempts at pregnancy, one or two embryos were implanted in the women.

The researchers found that half the 27 patients had no follicles at all, which meant the treatment could not help them, said Aaron Hsueh of Stanford University, senior author of the study. He also said researchers hope to find a way to stimulate follicles without removing the ovaries. .

Dr. Sherman Silber of the Infertility Center of St. Louis criticized the approach, saying he has had success by using drugs rather than surgery to treat the condition. He also disagreed with the researchers' explanation for why their treatment worked.

Some other experts said treatment with drugs often does not work.

The new results, experts cautioned, must be viewed as preliminary.

"It shows a lot of promise [but] I don't think it's even close to being ready" for routine use, said Dr. Mark Sauer of the Columbia University Medical Center in New York. Dr. Amber Cooper of Washington University in St. Louis called the technique "very much an experimental method."

The reported efficiency is very low, and the possible health risk to babies born from the method is unknown, said David Albertini of the University of Kansas Medical Center.

"One success does not mean we have a treatment … Stay tuned," he said.

He and others were also skeptical of the researcher's suggestion that the procedure would help women between ages 40 and 45. Eggs from women of that age often show genetic abnormalities, many of which would prevent a live birth, said Dr. Marcelle Cedars of the University of California, San Francisco Medical Center. Stimulating egg production wouldn't overcome that problem, she said.

Kawamura released a photo of himself holding the newborn shortly after he delivered him. He said the mother hopes to have another child with one of the frozen embryos in storage from her treatment.

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