Women's Health: Antidepressant drug linked with increased risk of birth defects ♦ Infertility treatments do not contribute to developmental delays in children

Infertility treatments do not appear to contribute to developmental delays in children Children conceived via infertility treatments are no more likely to have a developmental delay than children conceived without such treatments, according to a study. The findings may help to allay longstanding concerns that conception after infertility treatment could affect the embryo at a sensitive stage and result in lifelong disability

What are the risks of giving birth inside, outside a hospital setting? The out-of-hospital birth setting in Oregon was associated with a higher risk of perinatal death, while the in-hospital birth setting was associated with a higher risk for cesarean delivery and other obstetric interventions (e.g., induction or augmentation of labor), according a new American study.

Antidepressant drug linked with increased risk of birth defects when taken in early pregnancy Using paroxetine -- a medication prescribed to treat conditions including depression, obsessive-compulsive disorder, anxiety and posttraumatic stress disorder -- during the first trimester of pregnancy may increase newborn's’ risk of congenital malformations and cardiac malformations. Up to one-fifth of women of childbearing age experience depressive symptoms that often lead to mild to moderate depression, and prescriptions for antidepressants during pregnancy have increased in recent years. The most common drugs for treating depression in pregnant women are selective serotonin reuptake inhibitors, and up until 2005, one drug in that class -- paroxetine -- was considered to be safe for use during pregnancy.

Improving vaginal discomfort after menopause A new phase III trial with positive results is taking intravaginal DHEA a step closer to governmental approval. The formulation could provide women who cannot or do not wish to use intravaginal estrogen with an effective vaginal alternative for easing vaginal symptoms and pain with sex after menopause.

Women's Health: Timing of first childbirth influences women's health at age 40 ♦ Use aspirin to prevent preeclampsia ♦ Active and passive smoking linked to infertility

Timing of first childbirth influences women's health at age 40 A new study finds some surprising ways in which women's health at midlife is connected to when they had their first child and to their marital history.

Research offers recommendations for use of aspirin to prevent preeclampsia To prevent preeclampsia, new research suggests that low-dose aspirin should be given prophylactically to all women at high risk (those with diabetes or chronic hypertension) and any woman with two or more moderate risk factors (including obesity, multiple gestation and advanced maternal age).

Active and passive smoking linked to infertility and earlier menopause Active and passive smoking are linked to infertility problems and a hastening of the natural menopause before the age of 50.

Increased number of IVF cycles can be beneficial, findings suggest Although in vitro fertilization (IVF) is often limited to three or four treatment cycles, new research shows the effectiveness of extending the number of IVF cycles beyond this number.

Cancer Research: Suicide gene therapy kills prostate tumor cells ♦ Imaging test detects aggressive, treatment-resistant cancers ♦ Understanding of ovarian cancer

Imaging test detects aggressive, treatment-resistant cancers A new imaging test has been developed that could enable doctors to identify more dangerous tumors before they spread around the body -- and tailor treatment accordingly. Researchers describe detailed development of magnetic resonance imaging technology to map areas of oxygen deprivation within tumors.

Younger and older patients experience different symptoms from the same breast cancer drugs, The long-term outcomes in postmenopausal women who took two widely used breast cancer treatments have been analyzed. Researchers found that although both drugs were safe and effective, and had no detrimental effect on overall quality of life, there were some differences in the type and severity of symptoms the women experienced with each treatment, and these especially differed by age.

Fallopian tube organoids promise better understanding of ovarian cancer, infertility A new way of growing fallopian tube cells in culture is expected to give a boost to our understanding and prevention of female genital diseases, such as infertility, inflammatory disease, and ovarian cancer.

Suicide gene therapy kills prostate tumor cells Results from a long-term clinical trial conducted by cancer researchers show that combining radiation treatment with 'suicide gene therapy' provides a safe and effective one-two punch against the disease.

Women's Health: Polycystic ovary syndrome and diabetes linked.♦ Study pinpoints what part genes play in the age of first-time moms, family size ♦

Black women often cope with infertility alone African-American women are equally, if not more, likely to experience infertility than their white counterparts, but they often cope with this traumatic issue in silence and isolation.

Poly cystic ovary syndrome and diabetes: Researchers find out why the two are linked Nearly 50 percent of women with polycystic ovary syndrome (PCOS) develop prediabetes or type 2 diabetes before the age of 40, but the reasons for the correlation was unclear. Researchers report in a new study that inflammation is the cause for the increased diabetes risk in women with PCOS.

Study pinpoints what part genes play in the age of first-time moms, family size Researchers have analyzed the genomes of thousands of women in the UK and the Netherlands to measure the extent to which a woman's genes play a role for when she has her first baby and how many children she will have. Significantly, they have found that some women are genetically predisposed to have children earlier than others, and conclude that they have passed down their reproductive advantage to the next generation.

No waiting game: Immediate birth control implant more cost-effective Women who have just given birth are often motivated to prevent a rapid, repeat pregnancy. For those who prefer a contraceptive implant, getting the procedure in the hospital immediately after giving birth is more cost-effective than delaying insertion to a six-eight week postpartum visit.

Women's Health: Importance of counselling in those affected by infertility ♦ Overnight fasting reduces breast cancer risk ♦ Obstructive sleep apnea following childbirth

Why everything you've heard about women and negotiation might be wrong A student was listening to a lecture on a commonly held trope about negotiation -- that women are bad at it -- but the conventional wisdom didn’t fit with her experience at all. She did some new research and discovered that women who had experience with successful negotiation were superior negotiators to men,

Importance of counselling in those affected by infertility The psychological impact and private agony of infertility must be carefully considered by healthcare professionals. At present, the counseling role occupies a unique and diverse position within the infertility field, including that of patient advocate, gatekeeper, researcher, educator, supportive resource to colleagues, confidante and point of liaison,

Overnight fasting may reduce breast cancer risk in women A decrease in the amount of time spent eating and an increase in overnight fasting reduces glucose levels and may reduce the risk of breast cancer among women, report researchers. Women who fasted for longer periods of time overnight had significantly better control over blood glucose concentrations. The data shows that each three hour increase in nighttime fasting was associated with a 4 percent lower postprandial glucose level, regardless of how much women ate

Elevated upper body position improves respiratory safety in women following childbirth Although obstructive sleep apnea (OSA) is less common in young women, sleep apnea was found in 4.9 percent in a cohort of pregnant women. In addition, OSA worsens as pregnancy progresses and is likely to persist into the early postpartum period. An elevated upper body position might improve respiratory safety in women early after childbirth without impairing sleep quality,

New Treatment Increases Pregnancy Rate for Women with Infertility Disorder

The drug letrozole appears to be more effective than the standard drug clomiphene for helping women with polycystic ovary syndrome (PCOS) to achieve pregnancy, according to a large study from a research network supported by the National Institutes of Health.

PCOS affects from 5 to 10 percent of reproductive age women and may be the most common cause of female infertility, the study authors wrote. With PCOS, the ovaries are enlarged and contain multiple small cyst-like structures (immature ovarian follicles). Women with PCOS may produce an excess of male hormones, which interferes with ovulation. In addition to infertility, PCOS symptoms include irregular menstrual periods, excessive body and facial hair, acne, and obesity. Women with PCOS also may experience insulin resistance, a pre diabetic condition in which higher-than-normal amounts of insulin are produced to maintain normal blood glucose levels.

The researchers found that that women treated with letrozole not only were more likely to ovulate than were women treated with the standard drug, clomiphene, but were also more likely to have a live birth.

“This study showed conclusively that for this group of patients, treatment with letrozole resulted in proportionately more live births than did treatment with clomiphene,” said Louis V. De Paolo, chief of NICHD’s Fertility and Infertility Branch.

“We are extremely encouraged that letrozole could provide a new, oral, first line therapy for this common disorder,” Dr. Legro said. “A letrozole-based treatment potentially could provide a less invasive, less expensive therapy, with a much lower risk of multiple pregnancy.”

The study enrolled 750 infertile women with PCOS who were between 18 and 40 years of age, from February 2009 through January 2012 The women were assigned at random to receive either clomiphene or letrozole for 5 days, beginning on the third day of their menstrual cycle, for up to 5 monthly cycles If the women failed to ovulate or if their test results indicated that they produced insufficient progesterone following ovulation, the researchers increased the dose of the drug the women were being treated with during the next monthly cycle Women with test results indicating conception had occurred were followed until an ultrasound exam could confirm that a pregnancy had been established and throughout pregnancy until delivery.

Of the 374 women who received letrozole, 103 (27.5 percent) eventually had a live birth Of the 376 women who received clomiphene, 72 (19.1 percent) experienced a live birth The cumulative ovulation rate was higher for the letrozole group, with ovulation occurring 834 times in 1352 cycles, or 61.7 percent of the time The women in the clomiphene group ovulated 688 times out of a total of 1425 cycles, or 48.3 percent of the time.

There were no statistically significant differences between the groups for:

• Multiple pregnancy, with twin pregnancies occurring in 3.4 percent among the letrozole group and 7.4 percent of the clomiphene group
• Pregnancy loss (31.8 percent of the letrozole group and 29.1 percent of the clomiphene group
• Infants born with birth defects (3.9 percent with letrozole and 1.4 percent with clomiphene)

Women treated with letrozole had significantly fewer hot flashes than those treated with clomiphene, but more dizziness and fatigue.

Letrozole, currently used as a treatment for breast cancer in women who have gone through menopause, inhibits the production of estrogen, which influences the action of the brain’s hypothalamus and pituitary on the functioning of the ovaries Clomiphene prevents estrogen from binding to its target on the cell and so acts on the pituitary to cause the ovary to release the egg cell The study authors noted that one prior study suggested that letrozole might increase the risk of birth defects, but added that their study results do not support the earlier study’s findings Although their study did not uncover an increased risk of birth defects, the authors concluded that additional studies are needed to rule out whether letrozole could pose a similar or greater risk of birth defects than do other infertility treatments.