Fertility and pregnancy
Early cardiac activity predicts good IVF outcome
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A beating fetal heart 4 weeks after in vitro fertilization (IVF) predicts successful completion of the first trimester of pregnancy.
“Early ultrasound, in the patient with no history of miscarriage, is a very good predictor of a viable pregnancy,” Dr. Peter G. McGovern from the University of Medicine and Dentistry of New Jersey in Newark told Reuters Health.
McGovern and his colleagues measured fetal cardiac activity 4 weeks after IVF in 139 women undergoing fresh IVF cycles.
Drug for ecoptic pregnancy won’t harm ovaries
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Use of a single dose of the drug methotrexate to treat ectopic pregnancy does not appear to curb a woman’s fertility, according to Spanish researchers.
An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, usually in the fallopian tubes. These pregnancies can result in bleeding and death if the embryo is not removed, either surgically or with drug therapy.
To see whether methotrexate therapy for ectopic pregnancy impairs future fertility, researchers measured blood levels of a protein called anti-Müllerian hormone or AMH, which is an indicator of “ovarian reserve.”
Consent form developed for infertility therapy
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The Society for Assisted Reproductive Technology (SART) has developed a comprehensive document for doctors to use when obtaining informed consent from patients seeking infertility treatment.
“This is our compilation of the important elements of informed consent that should be reviewed with patients,” incoming SART president Dr. Elizabeth Ginsburg said in an interview with Reuters Health. “It’s designed to be used ‘as is,’ or it can be used by clinics to adjust their own consent forms.”
As presented at the American Society for Reproductive Medicine annual meeting in San Francisco, the form explains the different options available to patients, including, among others, in vitro fertilization and embryo frozen storage or “cryopreservation”.
Infections linked to premature births more common than thought, Stanford study finds
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Previously unrecognized and unidentified infections of amniotic fluid may be a significant cause of premature birth, according to researchers at the Stanford University School of Medicine.
An analysis of amniotic fluid from women in preterm labor indicated that 15 percent of the fluid samples harbored bacteria or fungi - an increase of 50 percent over previous estimates. The heavier the burden of infection, the more likely the women were to deliver younger, sicker infants.
“If we could prevent these infections in the first place, or detect them sooner, we might one day be able to prevent some of these premature births,” said research associate Dan DiGiulio, MD, who conducted the study in the laboratory of senior author David Relman, MD. About 12 percent of all births in this country are premature and the frequency of premature birth is increasing.
Testosterone unproven as yet for women’s sex woes
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Women should not take testosterone to treat loss of sexual desire until there is good evidence it is safe—and that it actually works—a behavioral scientist warns in a new report.
“I think that there is a lot of excitement about the use of androgens (‘male’ hormones) to treat low sexual desire in women that is based on evidence that looks better than it really is,” Dr. Leslie R. Schover told Reuters Health. “I think that the evidence has some significant flaws.”
Shover, a professor at the University of Texas M.D. Anderson Cancer Center in Houston and the author of the article in the journal Fertility and Sterility, adds: “This area of research is being driven by the incredible profits that pharma companies are expecting, given that one in three women in the US will rate herself as having low sexual desire.”
Preeclampsia may up risk of kidney disease
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Women who develop preeclampsia during pregnancy appear to be at increased risk for developing end-stage renal disease (ESRD) later in life—although the absolute risk is small—new research suggests.
Preeclampsia is a potentially serious condition that occurs in pregnancy, characterized by a dangerously high rise in blood pressure, protein in the urine, and an increased risk of having a premature infant.
“The biggest finding in our study is that preeclampsia is associated with a 4- to 5-times increased risk of ESRD. We were surprised that the association was that strong,” lead researcher Dr. Bjorn Egil Vikse told Reuters Health.
Newest fertility treatment may be a diet
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The newest low-tech fertility treatment may be a diet, researchers said on Wednesday after learning that obese men have more abnormal sperm and make less semen.
Their findings, presented at a meeting of the European Society of Human Reproduction and Embryology in Barcelona, Spain, add to recent research showing that obese women are more likely to be infertile.
“We felt that it was possible that male overweight might contribute to fertility problems, particularly since it is a known risk factor for problems in conceiving among women,” said Dr. Ghiyath Shayeb of the University of Aberdeen in Scotland.
New fertility technique targets women with cancer
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A new technique may help newly diagnosed cancer patients preserve their eggs, and perhaps their fertility, before chemotherapy, German researchers said on Monday.
Currently, many women collect and freeze some of their eggs to try to have children after their cancer treatment, which can make them infertile. The process can take up to six weeks.
However, if a cancer diagnosis comes at the start of the menstrual cycle, many women are unable to delay chemotherapy and preserve their eggs, Michael Von Wolf told the European Society of Human Reproduction and Embryology.
Men past 40 face fertility problems: researchers
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Couples trying to have a baby when the man is over 40 will have more difficulty conceiving than if he is younger, French researchers said on Sunday.
Doctors know a woman’s age plays a key role but the findings presented at the European Society of Human Reproduction and Embryology conference suggest the paternal impact is stronger than has been thought, Stephanie Belloc and colleagues said.
“Our data give evidence for the first time for a strong paternal effect on IUI (intrauterine insemination) outcome either on pregnancy rates but also on miscarriage rates,” Belloc and her team from the Eylau Centre for Assisted Reproduction in France said.
Promoting sexual and reproductive rights
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Elsevier announced today Reproductive Health Matters’ May 2008 issue on the theme of “Conflict and Crisis Settings: Promoting Sexual and Reproductive rights”. Under conditions of global economic and ecological crisis as well as rampant militarism, growing numbers of refugees and internally displaced persons (IDPs) find themselves stripped of ordinary rights or even ‘the right to have rights’. By the end of 2006, the United Nations High Commission on Refugees (UNHCR) estimated that nearly 33 million people worldwide qualified for humanitarian assistance – representing an increase of 56% from 2005. The great majority of these were IDPs who do not qualify for the rights and benefits conferred by refugee status.
Disaster has a strongly gendered dimension related to sexual and reproductive health. Camps and shelters which are intended to provide refuge often become places of violence and dehumanisation, especially for women and girls. This issue of Reproductive Health Matters attests to the great distance that remains between the official recognition of the sexual and reproductive rights of IDPs and refugees and their safeguarding on the ground.
The long-term duration of armed conflict in many countries means that IDPs and refugees may find themselves displaced for years or even decades. Conditions of unequal power, dependency, crowding, sub-standard housing and lack of privacy make rape and abuse a constant threat.
Severe Insulin Resistance may Increase Rate of Pregnancy and Birth Complications
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Testing pregnant women for insulin resistance with a simple blood test may be a new tool for predicting problems during pregnancy, according to a new study. The results will be presented at The Endocrine Society’s 90th Annual Meeting in San Francisco.
Insulin resistance is a condition in which the body blocks the effects of the hormone insulin. As a result, glucose, or sugar, builds up in the blood, and diabetes can develop. Insulin resistance lies behind the development of gestational diabetes - diabetes that develops during pregnancy - which increases the risk of pregnancy and birth complications. Therefore, the authors aimed to find out whether insulin resistance is linked to poor outcomes in pregnant women and newborns, said the lead author, Weerapan Khovidhunkit, MD, PhD, of Chulalongkorn University, Bangkok, Thailand.
It is standard for pregnant women to get a blood test for gestational diabetes between the 24th and 28th weeks of pregnancy, according to The Hormone Foundation, the public education affiliate of The Endocrine Society. This test is called the glucose challenge test or glucose challenge screening. If this test result is positive, the woman then has an oral glucose tolerance test (OGTT), in which her blood sugar levels are tested 3 hours after she drinks a glucose drink.
Disabling mouse enzyme increases fertility
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Changing the sugars attached to a hormone produced in the pituitary gland increased fertility levels in mice nearly 50 percent, a research group at Washington University School of Medicine in St. Louis has found. The change appears to alter a reproductive “thermostat,” unveiling part of an intricate regulatory system that may one day be used to enhance human fertility.
“To adjust for the right amount of key reproductive hormones such as estrogen and testosterone, we may someday alter the sugars that are added to this hormone or others like it,” says the group’s leader, Jacques Baenziger, M.D., Ph.D., professor of pathology and immunology and of cell biology and physiology.
The report appeared recently in The Journal of Clinical Investigation.
Exercise may reduce risk of preterm birth
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Women who are physically active during pregnancy may lower their chances of delivering prematurely, according to findings from a Danish study,
Using the Danish National Birth Cohort database, Mette Juhl, of the National Institute of Public Health, in Copenhagen, and colleagues analyzed physical activity information reported by 87,232 pregnant women between 1996 and 2002.
Overall, about one-third of the women said they participated in physical exercise, such as swimming, or low-impact leisure time activity such as aerobics, dancing, walking or hiking, bicycling, and yoga during early pregnancy.
Skipping breakfast may mean your baby is a girl
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Women on low-calorie diets or who skip breakfast at the time of conception are more likely to give birth to girls than boys, British scientists said on Wednesday.
New research by the universities of Exeter and Oxford provides the first evidence that a child’s sex is associated with the mother’s diet, and higher energy intake is linked to males.
“This research may help to explain why in developed countries, where many young women choose to have low-calorie diets, the proportion of boys born is falling,” said Fiona Mathews of the University of Exeter.
Biology of Reproduction highlights
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For young male offspring who suffer a dominant mother, a brother may be on the way to help bear the burden. And all because of follicular testosterone. A growing body of evidence suggests a maternal influence on sex determination: dominant human females conceive more sons. Grant et al., in an article on p. 812 of the May issue of Biology of Reproduction, find that the sex of bovine embryos positively correlates with pre-ovulatory follicular testosterone. How exposure of oocytes to follicular testosterone may influence the ability of a metaphase II egg to be preferentially inseminated by a Y-bearing sperm remains a mystery. What is known is that chronic stress elevates testosterone in females (but not males). So if you would like your next sibling to be a sister, don’t aggravate your mother.
Sex of Bovine Embryos May Be Related to Mothers’ Preovulatory Follicular Testosterone. V. J. Grant, R. J. Irwin, N.T. Standley, A. N. Shelling, and L. W. Chamley. Biol Reprod 2008; 78:812-815. Published online in BOR Papers-In-Press 9 January 2008; DOI 10.1095/biolreprod.107.066050
