Vietnam - ASEAN-EU review science, technology ties

The Hanoitimes - The closing meeting for the ASEAN-EU Year of Sciences, Technology and Innovation 2012 (YoSTI 2012) was jointly organised by the SEA-EU NET project and the EU Committee in Brussels, Belgium.

YoSTI 2012, initiated in November, 2011, witnessed approximately 40 events in ten Southeast Asian countries and the EU. It aimed to boost scientific and technological cooperation between the two regions.

The event created favourable conditions for researchers and policy-makers to meet and discuss the results and benefits of research activities and the bi-regional cooperation potential.

The meeting’s reports revealed the key outcomes and impacts o­n the future of ASEAN-EU collaboration.

During the engagement, high-level policy-makers from the EU and ASEAN, as well as researchers, research managers and members of key research institutions assessed how synergy in science and technology between the EU and the ASEAN region can be created.

It was mutually agreed that the emerging scientific ties create opportunities for scientists to jointly explore new technology potentials, such as gene and nano-technology, increase agricultural productivity, figure out smarter approaches to produce and conserve energy, and seek secure provision of food and clean water in the two regions.

Europe - Moderate coffee consumption may reduce risk of diabetes by up to 25 percent

Drinking three to four cups of coffee per day may help to prevent type 2 diabetes according to research highlighted in a session report published by the Institute for Scientific Information on Coffee (ISIC), a not-for-profit organisation devoted to the study and disclosure of science related to coffee and health.

Recent scientific evidence has consistently linked regular, moderate coffee consumption with a possible reduced risk of developing type 2 diabetes. An update of this research and key findings presented during a session at the 2012 World Congress on Prevention of Diabetes and Its Complications (WCPD) is summarised in the report.

The report outlines the epidemiological evidence linking coffee consumption to diabetes prevention, highlighting research that shows three to four cups of coffee per day is associated with an approximate 25 per cent lower risk of developing type 2 diabetes, compared to consuming none or less than two cups per day1. Another study also found an inverse dose dependent response effect with each additional cup of coffee reducing the relative risk by 7-8 per cent.

Whilst these epidemiological studies suggest an association between moderate coffee consumption and reduced risk of developing diabetes, they are unable to infer a causal effect. As such, clinical intervention trails are required to study the effect in a controlled setting. One prospective randomized controlled trial3, tested glucose and insulin after an oral glucose tolerance test with 12g decaffeinated coffee, 1g chlorogenic acid, 500 mg trigonelline, or placebo. This study demonstrated that chlorogenic acid, and trigonelline reduced early glucose and insulin responses, and contribute to the putative beneficial effect of coffee.

The report notes that the association between coffee consumption a reduced risk of type 2 diabetes could be seen as counter intuitive, as drinking coffee is often linked to unhealthier habits, such as smoking and low levels of physical activity. Furthermore, studies have illustrated that moderate coffee consumption is not associated with an increased risk of hypertension, stroke or coronary heart disease. Research with patients with CVD has also shown that moderate coffee consumption is inversely associated with risk of heart failure, with a J-shaped relationship.

Finally, the report puts forward some of the key mechanistic theories that underlie the possible relationship between coffee consumption and the reduced risk of diabetes. These included the 'Energy Expenditure Hypothesis', which suggests that the caffeine in coffee stimulates metabolism and increases energy expenditure and the 'Carbohydrate Metabolic Hypothesis', whereby it is thought that coffee components play a key role by influencing the glucose balance within the body. There is also a subset of theories that suggest coffee contains components that may improve insulin sensitivity though mechanisms such as modulating inflammatory pathways, mediating the oxidative stress of cells, hormonal effects or by reducing iron stores.

Dr. Pilar Riobó Serván, Associate Chief of Endocrinology and Nutrition, Jiménez Díaz-Capio Hospital of Madrid and a speaker at the WCPD session concludes the report, commenting: "A dose-dependent inverse association between coffee drinking and total mortality has been demonstrated in general population and it persists among diabetics. Although more research on the effect of coffee in health is yet needed, current information suggests that coffee is not as bad as previously considered!"

Provided by European Science Foundation

http://medicalxpress.com

France - Asian mosquito gains foothold in Europe

MONTPELLIER, France - Behind air-tight doors in a lab in a southern French city, scientists in protective coveralls wage war against a fingernail-sized danger.

Lurking in net cages is their foe: the Asian tiger mosquito, capable of spreading dengue fever and other tropical diseases in temperate Europe.

First spotted in Albania in 1979, the black-and-white striped invader has gained a foothold on Europe's Mediterranean rim and is advancing north and west, according to captors' reports.

Colonies are established in 20 European countries, in moderate climes as far north as Germany, Belgium and the Netherlands.

"The risk of disease is very low but it is growing," entomologist Jean-Baptiste Ferre told AFP at France's leading mosquito-control institute.

"The more mosquitoes there are, the higher the risk."

The Asian tiger mosquito - Latin name Aedes albopictus - can spread many kinds of viruses.

They include dengue, which can result in a deadly haemorrhagic fever, as well as West Nile virus, St. Louis encephalitis and a painful disease of the joints called chikungunya.

A. albopictus transmits the virus by taking blood from a sick person and handing on the pathogen the next time it takes a meal.

The worry is that the insect will spread disease in Europe by biting infected people arriving from tropical countries where the viruses are endemic.

In 2007, the tiger mosquito caused a home-grown outbreak in Italy of chikungunya, and in 2010, 10 locally-transmitted cases of dengue occurred in Croatia.

That same year, two cases of each disease surfaced in southern France, prompting the alarm bells to ring loudly.

From Montpellier, Ferre and his colleagues at the Entente Interdepartementale pour la Demoustication en Mediterranee (EID) monitor the spread with some 1,500 traps dotted around France, luring mosquitoes to lay their eggs.

These provide insights into how A. albopictus is adapting to European life, with its varied habitats and cooler climate.

Ferre points to maps that begin in 2004, when a tiny red dot represented the first settling of albopictus in France around Menton, near the Italian border.

Year by year, the dot grows into red tentacles that probe north and west.

The insect has a flight range of only about 200 metres, so it hitch-hikes a ride in cars, trucks and traded goods.

With climate change, "further expansion is probable," the journal Vector-Borne and Zoonotic Diseases warned this year.

That assessment is supported by scientists at Britain's University of Liverpool who point to warming trends in the Balkans and northwestern Europe.

Asian tiger mosquitoes are aggressive and robust, able to breed prolifically in their short, 10-day lives.

Feeding during the day, they can bite several people in quick succession, and their offspring can hatch even after long periods without water.

Worse, the insect is a stealthy urban dweller.

It does not need large, open bodies of water to reproduce, for it can lay its eggs in small, water-holding receptacles such as flowerpots, toys and blocked gutters, and this makes it much harder to fight.

Since May this year, surveillance in France has thrown up 267 suspected dengue and chikungunya cases among people who had arrived from abroad, said EID project coordinator Gregory Lambert.

AFP

Europe - High-carb diet tied to breast cancer risk for some

Older women who eat a lot of starchy and sweet carbohydrates may be at increased risk of a less common but deadlier form of breast cancer, a new study suggests.

The findings, from a study of nearly 335,000 European women, do not prove that your French fries, sweets and white bread contribute to breast cancer.

But they do hint at a potential factor in a little understood form of breast cancer, according to a researcher not involved in the work.

Specifically, the study found a connection between high "glycemic load" and breast cancers that lack receptors for the female sex hormone estrogen.

A high glycemic load essentially means a diet heavy in foods that cause a rapid spike in blood sugar. The usual culprits include processed foods made from white flour, potatoes and sweets. A sweet, juicy piece of fruit can also raise blood sugar quickly. But since fruits are low in calories, they don't contribute as much to your diet's glycemic load.

So-called estrogen receptor (ER)-negative tumours account for about one-quarter of breast cancers. They typically have a poorer prognosis than ER-positive cancers because they tend to grow faster and are not sensitive to hormone-based therapies.

In this study, postmenopausal women whose diets were very high in glycemic load had a 36-per cent higher risk of ER-negative breast cancer, compared with women whose diets had the lightest load.

In general, a diet with a high glycemic load is not a particularly healthy one, noted Christina Clarke, a research scientist at the Cancer Prevention Institute of California in Fremont, and a consulting assistant professor at Stanford University.

"These types of diets have been associated with many negative health outcomes," said Clarke, who was not involved in the study.

So although the current findings do not prove cause-and-effect, they can give women another reason to make healthier diet choices, according to Clarke.

Lead researcher Isabelle Romieu, of the International Agency for Research on Cancer in Lyon, France, did not respond to an email request for an interview.

From a scientific standpoint, Clarke said the results are interesting because so little is known about what causes ER-negative breast cancers. Most breast tumours - the ER-positive ones - have their growth fueled by estrogen.

"We really don't know anything about what causes (ER-negative) tumours," Clarke said. "This study gives us a really important clue for future research."

Diets with a high glycemic load are associated with a bigger secretion of insulin, a hormone that regulates blood sugar. High insulin levels, in turn, have been linked to certain cancers, possibly because insulin helps tumours grow.

The current findings hint at a role for "insulin pathways" in ER-negative breast cancer, according to Clarke. "But there's definitely more work that needs to be done," she said.

The findings, which appear in the American Journal of Clinical Nutrition, are based on a long-running European study on nutrition factors and cancer risk.

Of nearly 335,000 women in the study, 11,576 developed breast cancer over a dozen years. Overall, there was no link between breast cancer risk and glycemic load - estimated from diet questionnaires the women completed at the study's start.

But the picture changed when the researchers focused on postmenopausal women with ER-negative cancer. Among women in the top 20 per cent for glycemic load, there were 158 cases of breast cancer, versus 111 cases in the bottom 20 per cent.

When breast tumours also lacked receptors for the hormone progesterone, the gap was a bit more pronounced.

Still, the numbers "weren't huge," Clarke noted. And there are many other factors that could be different between those groups of women, although the study did account for some of them, including weight, exercise habits, calorie intake and smoking.

Clarke pointed out that there is no single factor in any woman's risk of breast cancer. But, she said, the findings offer more incentive to eat a balanced diet that limits refined carbs in favour of healthier fare - like lean protein, vegetables, "good" fats and high-fiber grains.

"Really, you want to avoid these (high glycemic load) diets anyway," Clarke said.

Reuters

Europe - The EU definition of nanomaterials – Getting what you wished for?

To gain public trust, nanotechnology needs a regulatory framework – but before this can be happen we need to know one thing – just what is a nanomaterial? Jeremy Warren tells us about a definition that could ease the legislative deadlock

Since first citations of the term “Nanotechnology”, scientific, industrial, public and political stakeholders have called for a robust regulatory framework to address the potential toxicological concerns surrounding these exciting new materials. It is the promise of novel and useful properties from nano sizes of familiar materials that prompts a reappraisal of our knowledge of their potential toxicology and environmental impact. These are effectively new materials.

The argument goes that, without public and political confidence, this new science risks fear and distrust, rather than being embraced as providing a multitude of solutions to challenges in the fields green energy, world food production or pharmaceutical advancement, to name but a few

In October 2011 the EU Commission published a recommended definition of Nanomaterials1. This definition is not the complete framework, but it is a significant step towards it. Observers of embryonic nanotechnology regulation recognised this definition as the missing jigsaw piece in planned legislation and subsequently witnessed the French government largely adopting the definition’s wording and getting draft legislation on compulsory labelling of Nanomaterials out for consultation in less than three months.

Meanwhile other stakeholders in fields including nanomaterial manufacture and workplace exposure, handling, labelling, transportation and environmental fate now find they have an authoritative definition to slot into nascent regulation.

The key points of the definition are these:

1)     It is a Nanomaterial if any of these three criteria are met:

a)     At least 50% of the particles by count have one dimension external between 1 and 100nm.

b)    The material has a surface area greater than 60m2/cm3.

c)     The substance appears on an “include” list that captures materials such as graphene, which would otherwise fall outside the definition.

2)     The definition includes naturally-occurring as well as manufactured and incidentally manufactured particles.

3)     There are no specific recommendations on characterisation methods to meet these specifications.

4)     The definition is a recommendation, not a regulation; however its provenance bestows authority.

Despite protracted and energetic attempts by SCENIHR (the Scientific Committee on Emerging and Newly Identified Health Risks, part of the Directorate General for Health and Consumers) to draw stakeholders into consultation, much of industry and the scientific community appear taken by surprise here.

One can sympathise with the compliance officers in, for example, tyre manufacture or cement production, which suddenly find themselves within the nanotechnology industry.

Sympathize one might, but now a period of reflection is required to understand the scientific logic that generated this definition.

Reading back through SCENIHR’s publication, Scientific Basis for the Definition of the Term “Nanomaterial”,they describe in depth the reasoning behind the definition. SCENIHR exhaustively discuss the possible measures and their benefits, and make clear the large areas of ambiguity and difficulty in these judgments. Then, with some moral courage, they draft this definition, and in so doing take a step forward in supplying the urgent need for regulation.

The 100nm upper limit is essentially historic, coming from original definitions in nanotechnology. It was arbitrary then, and is so now, but it is a starting point.  Given this definition is specific to regulation, these numbers have to be precise to be enforceable. Specifying count rather than weight per cent recognises that chemical reactivity increases per mass dose for smaller particles. Parameters more closely relating to potential toxicity are missing – these are likely to follow on from this initial size-based definition.

Regarding the lack of recommended characterisation methodologies, one need look no further than diesel combustion emissions or the water industry for precedents, where regulatory need sets scientists a measurement challenge – and maybe that is the right way to drive development of practical measurement methodologies?

Let me clearly state my interest here – NanoSight’s NTA (Nanoparticle Tracking Analysis) is at least a partial solution to the nanoparticle counting requirement, and in combination with occasional electron microscopy to inform the bottom end of the 1 – 100nm range, we have a practical, readily-implementable solution.

As the dust settles following the initial publication, reflect on the significant positive drivers from industry in support of legislation. Big business surely seeks to see nanotechnology de-risked? Potential adverse public reaction hangs over nanotechnology, limiting investment and curbing strategic intent. More cynically perhaps, big business deals better with regulation than SMEs; here is a barrier to entry that will ultimately lead to profitability in this sector.

To conclude, we welcome this definition as a starting point to deliver regulation on potential toxicity. There is much research work to be done, and having this definition, this building block in place, will surely enable government investment in research to go the next steps, from simple physical parameters to the far more complex challenges of bioavailability and biointeraction at the heart of toxicology.

If industry and regulators can get this right, then far from labeling “contains nanomaterial” being in the smallest permissible font, we might see “Contains Nano” in a bright splash of colour, implying progressiveness, advanced and useful technology,  and above all, trustworthiness.

Reference:

1.     http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2011:275:0038:0040:EN:PDF

Kerry Taylor Smith

http://www.labnews.co.uk/

China - First TCM Drug Approved In EU Market

The European Union has approved a Chinese traditional drug for sale in a European market for the first time, the Chinese Academy of Sciences announced on Wednesday.

The European Union has approved a Chinese traditional drug for sale in a European market for the first time, the Chinese Academy of Sciences (CAS) announced on Wednesday.

Di’ao Xin Xue Kang (地奥心血康), a cardiovascular drug produced by the Chengdu-based Di’ao Group, received marketing authorization from the Medicines Evaluation Board of the Netherlands.

“This is an important step for TCM to enter mainstream markets of developed countries,” the Chinese Health Minister Chen Zhu said at a CAS news conference in Beijing on Wednesday.

The certification of Di’ao Xin Xue Kang follows an EU ban on traditional Chinese medicine in May 2011, imposed to prevent unlicensed herbal medicines being sold as food supplements.

“The medicine is also the first herbal medicine that has entered the EU market from a country outside the EU member states,” said Li Bogang, president of the Di’ao Group.

Although the medicine has been widely sold in China since 1998, it took the group six years to obtain the certification from the Netherlands, said Li. Through a collaboration with the Netherlands Organization for Applied Scientific Research, the group managed to identify the active substance in Di’ao Xin Xue Kang.

Another seven or eight Chinese TCM firms are working on getting EU approvals, according to the China Academy of Chinese Medical Sciences.

Bai Chunli, president of Chinese Academy of Sciences, urged TCM research institutions to increase their focus on the European Union, to help more medicines gain access to high-end markets.

——

Source: Chinese Academy of Sciences

Asian Scientist Newsroom | Tech & Pharma

China - New Association For Good Practice In Chinese Traditional Medicine Research

Scientists from Europe and China have officially launched a new association to research traditional Chinese medicines.

Scientists from Europe and China have officially launched a new association to research traditional Chinese medicines (TCM).

The new association, called the Good Practice in Traditional Chinese Medicine Research Association (GP-TCM), will help researchers to explore age-old remedies in the search for tomorrow’s new drugs. It also hopes to further understand links between western and Chinese medicines.

King’s College London scientists Dr. Qihe Xu and Professor Peter Hylands were among twelve scientists from seven countries and regions who were elected as Directors of the new Association.

“So far, the 7th Framework Program consortium has engaged more than 200 scientists and clinicians from 112 institutions in 24 countries in discussions about good practice in various aspects of Chinese herbal medicine and acupuncture research, culminating in recent best-practice guidelines published in the Journal of Ethnopharmacology,” said Xu.

Xu explained that the GP-TCM Research Association was founded to promote high-quality evidence-based TCM research, and to promote the sustainable development of TCM research worldwide.

“We believe that the challenges of TCM research can only be solved in an interdisciplinary network, using the most advanced methodologies of the post-genomic era,” said the association’s founding president, Professor Rudolf Bauer of the University of Graz.

Asian Scientist Newsroom | Top News

Europe - e-Health, the next big step for cloud computing

Cloud computing is getting bigger as time goes by, and technology is changing our daily lives. The next big IT goal is healthcare computing, which is expected to grow in the coming years, but not only in developed countries. It also has big potential in the EU.

The global economic recession has made major suppliers of technology less interested about investing in developed countries. Funds for healthcare development in Europe are decreasing, and emerging economies in Asia-Pacific are seen as more attractive markets than European countries or the US.

According to a new report published by business intelligence analysts, GBI Research, despite the economic recession, European countries still care strongly about health issues, and using the latest technologies to improve developments in the healthcare sector; which is where cloud computing comes in. The report also says that the advantages offered by cloud computing include the reduction of costs, improved accessibility of applications and off-site management of data, which increases efficiency and security in data management.

The EU's e-Health programme defends and promotes tools based on information and communication technologies used to assist and enhance the prevention, diagnosis, treatment, monitoring, and management of health and lifestyle. The plan refers to, for example, interaction between patients and health-service providers, institution-to-institution data transmission, or peer-to-peer communication between patients or health professionals.

Co-ordinating actions and promoting synergies between related policies and stakeholders is EU’s priority to move towards a ‘European e-Health Area’. Some of the specific objectives are to create an electronic health record architecture, to set up health information networks between points of care, to ensure online health services such as information on healthy living and illness prevention and to develop tele-consultation, e-Prescribing, e-Referral and e-Reimbursement capabilities.

The first action of the eHealth plan started in 2004 and finished in 2010.The objective was to call member states to develop tailored national and regional e-Health strategies to respond to their own specific needs. Now, the new action plan for 2012-2020, seeks to consolidate the actions that have been addressed to date and take them a step further, in the context of the EU 2020 Strategy and the Digital Agenda for Europe.

In addition, these are also being applied at an international level. Europe and the US signed a Memorandum of Understanding (MoU) in December 2010 to promote a common approach on the interoperability of electronic health records and on education programmes for information technology and health professionals.

e-Health offers lots of benefits to medical device suppliers and their customers, but some aspects need attention. Everything related with Healthcare needs high data protection and security, but cloud computing often sends data through insecure connections. Encryption technologies seem promising, but have not yet satisfied industry needs.

Another concern about cloud-based medical devices is geographical storage. Some countries defend the idea of retaining their citizen’s data inside the country, where their laws have jurisdiction.

Trying to solve this concern, the European Patients Smart Open Services (epSOS) presented on 13 April a pilot cross-border e-Health service, co-founded by the European Commission. After three years of working, their efforts have culminated in the large scale pilot entering into operational mode.

From now on, European patients that want to take part in the epSOS pilot, as well as spSOS health professionals, can use and evaluate the cross-border patient summary, e-Prescription and e-Dispensation services. The main objective of the project is to demonstrate that medical treatment for citizens residing in other countries can be improved by providing health professionals with the necessary patient data in a secure electronic format to give them a second opinion.

There is still a long way to go for ICT- related e-Health policies, and a lot of actions must be taken to transform the healthcare system from physician-centric to patient-centric.

The key to making it easier to obtain these objectives, according to the European Commission, is to facilitate co-operation between regions and states.

NEREA RIAL

http://www.neurope.eu

UK - Fertility treatment bans in Europe draw criticism

LONDON (AP) -- More than three decades after Britain produced the world's first test-tube baby, Europe is a patchwork of restrictions for people who need help having a child.

Many countries have strict rules on who is allowed to get fertility treatments. And recent court rulings suggest nothing's likely to change anytime soon.

France and Italy forbid single women and lesbian couples from using artificial insemination and in vitro fertilization, or IVF, to conceive. Austria and Italy are among those banning all egg and sperm donations for IVF. Germany and Norway ban donating eggs, but not sperm.

Countries including Sweden require couples to have a stable relationship for at least a year to qualify for fertility treatment. Switzerland, among others, requires couples to be married.

And nearly everywhere in Europe except Ukraine, couples are banned from hiring a woman to carry a pregnancy for them.

"These laws are completely out of date," said Dr. Francoise Shenfield, a fertility expert at University College London.

"It's a medical treatment and the decision to treat should be up to doctors," not judges, said Shenfield, an ethics expert for the European Society for Human Reproduction and Embryology.

Placing bans on egg and sperm donation is "discriminating against infertile couples," she added, although she acknowledged there were valid medical reasons for not treating some patients, like women over 50.

The European laws stand in contrast to comparatively few restrictions elsewhere, including in the U.S., Australia, Brazil and Canada.

Experts estimate thousands of Europeans travel to another country each year for help having a baby, though exact figures aren't recorded. Many are single women who go abroad to get artificial insemination, which is banned for single women in countries including Sweden, Germany and Italy.

Marie Eriksson, a 36-year-old single mother in Sweden, described the restrictions as prejudice. "Having a child is not a right, but the possibility should not be forbidden because you don't have a partner," she said.

Eriksson, a librarian, traveled to a fertility clinic in Denmark after deciding she wanted to have a child on her own. "The alternative was to go out and meet a stranger at a pub," she said.

She gave birth to her daughter, Sonja, in 2008. "It was totally worth it," she said of the seven treatments she paid for.

Reasons for the restrictions vary from country to country. Many cite concerns about creating "unnatural" relationships between donors, parents and children. Others are driven by religious or cultural objections.

Recent attempts to change the laws have so far failed. Last November, the European Court of Human Rights upheld an Austrian regulation that forbids using sperm and egg donors for IVF.

In that case, two married couples sued the Austrian government, arguing the ban violated their right to a "private and family life" under the European Convention on Human Rights. The court ultimately ruled the restriction was justified and cited problems like "splitting motherhood" between a biological mother and the woman carrying the fetus.

"I'm often dumbfounded by the position some European countries take on IVF," said Dr. Norbert Gleicher, medical director of the Center for Human Reproduction, a private clinic in New York City.

The restrictions in many European countries would be unthinkable in the U.S., Gleicher said, adding about 40 percent of his patients travel from abroad, many from Europe.

In Sweden, lawmakers are considering whether to change the law so that all single women have access to fertility treatment.

Eriksson said the restrictions no longer match reality. "There are so many different kinds of families today that it is not sustainable to maintain laws and regulations based on traditional family ideals," she said.

For IVF, women must undergo hormone stimulation to produce eggs and a procedure to extract them from the ovaries. Embryos are created by mixing sperm and eggs together in a lab, then transferred into a woman's womb.

Fertility treatment remains a taboo subject in many countries.

Germany's history of eugenics - where Nazi doctors forcibly sterilized or euthanized people in an attempt to eliminate hereditary illnesses and handicapped people - makes officials nervous about any procedures that handle embryos. It was only last year that Germany approved an embryo test commonly used elsewhere to spot genetic problems. The test, generally used only in IVF pregnancies, is still banned in Austria and Italy.

In other countries, religion carries more weight. France and Italy both have strong historic ties to the Roman Catholic Church, which forbids IVF, primarily because the procedure may involve the destruction of embryos. The church is also against artificial insemination because it believes procreation should only be by a husband and wife through the natural act of sex.

Until 2004, Italy's fertility laws were fairly lax, leading to pregnancies in women as old as 60, and a proliferation of woman "renting" their wombs. A law supported by leading Catholic groups that year clamped down on egg and sperm donation, limited the number of embryos transferred, and outlawed the practice of freezing embryos. The law restricts IVF to "stable, heterosexual couples who live together and are of childbearing age."

Italy says allowing donated eggs could exploit women and that the practice "would lead to a weakening of the entire structure of society."

Most couples seeking fertility treatments don't need donated eggs and sperm. And many government health systems will pay for fertility treatments for those who have been trying at least three years to conceive.

People in Western Europe who seek medical treatment elsewhere cannot be prosecuted at home even if the treatment is illegal in their own country. But there can be other complications. For example, in France, children born through surrogacy are not entitled to a French passport.

Still, authorities are struggling with how to deal with the complexity of IVF families. Last month, France's Court of Appeal upheld a decision to grant civil status - similar to nationality - to twins carried by a surrogate mother in India for a French couple. But in 2011, the French Supreme Court denied civil status to twins born to a surrogate mother in the U.S.

For gay and lesbian couples in France, Italy, Switzerland and elsewhere, only one partner can be the child's legal father or mother.

"These restrictions imply that gays and lesbians are second-class citizens and that a child has to be raised in a conventional family," said Angelo Berbotto, a lawyer and acting secretary of NELFA, Europe's largest organization for gay and lesbian families.

Opponents say national health systems are not obligated to allow artificial reproduction techniques for same-sex couples.

"The desire to be a parent does not create the right to have children," said Gregor Puppinck, director general of the European Center for Law and Justice, a Christian group that lobbies European lawmaking bodies.

"What's lost is the best interests of the child," Puppinck said. "The child has a right not to have two fathers or two mothers."

Dr. Heinz Strohmer, a fertility doctor at a Vienna clinic, said most of his clients needing egg or sperm donations were more concerned about the logistics of getting treatment abroad than challenging Austria's law banning them.

"The only question they have is if we can organize everything for them," he said. Strohmer often works with clinics in the Czech and Slovak republics and Spain to get around the Austrian rules on IVF.

When Italian residents Giuseppina La Delfa and Raphaelle Hoedts decided to have a baby, they knew that would mean crossing borders. Needing a sperm donation for IVF that they couldn't get in Italy, the lesbian couple went to Belgium for more than a dozen cycles of fertility treatment. La Delfa gave birth to daughter Lisa-Marie in 2003.

"It was very difficult and it cost a lot of money, but it was the only way," said La Delfa, a 49-year-old French teacher. "Nothing was more important to us than her."

La Delfa considers the restrictions imposed on IVF for lesbian and gay couples not only archaic, but ineffective.

"They think there's only one way to be a parent," she said, of governments that ban fertility treatments. "They don't realize people will do whatever it takes to have a family."

For the two women, that meant another IVF trip last year, this time to Spain. Hoedts is currently pregnant with the couple's second child.

La Delfa said Lisa-Marie, now 8, is proud of her unusual origins.

"I joke with her that her big ears come from her donor," La Delfa said.

MARIA CHENG

AP Medical Writer

Fertility group: http://www.fertilityeurope.eu/