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November 9, 2010, 10:52 PM CT

Overcoming the IVF Baby Blues

Overcoming the IVF Baby Blues
Between 20 and 30 percent of women who undergo in vitro fertilization (IVF) procedures suffer from significant symptoms of depression. A number of practitioners think that the hormone treatment involved in IVF procedures is primarily responsible for this. But new research from Tel Aviv University shows that, while this is true, other factors are even more influential.

As per Dr. Miki Bloch of Tel Aviv University's Sackler Faculty of Medicine and the Sourasky Medical Center in Tel Aviv, stress, pre-existing depression, and anxiety are more likely than hormone treatment to impact a woman's depression levels when undergoing IVF. Combined, these factors may also affect IVF success rates - so diagnosis and therapy of this depression is very important.

Recently published in the Journal of Fertility and Sterility, Dr. Bloch's research clarifies the involvement of different hormonal states as triggers for depression during IVF, both for long- and short-term protocols.

The long and short stories

In the long-term IVF protocol, explains Dr. Bloch, women receive injections which block ovulation, resulting in a sharp decline in estrogen and progesterone levels. This state continues for a two-week period before the patient is injected with hormones to stimulate ovulation, at which point the eggs are harvested and fertilized before being replanted into the womb. The short-term IVF protocol, conversely, does not include the initial two-week period of induction of a low hormonal state.........

Posted by: Emily      Read more         Source


November 1, 2010, 8:00 AM CT

Women with anorexia and unplanned pregnancies

Women with anorexia and unplanned pregnancies
Image source: Norwegian Institute of Public Health
A newly released study by University of North Carolina at Chapel Hill and Norwegian scientists has observed that women with anorexia nervosa are much more likely to have both unplanned pregnancies and induced abortions than women who don't have the serious eating disorder.

These results appears to be driven by a mistaken belief among women with anorexia that they can't get pregnant because they are either not having menstrual periods at all or are having irregular periods, said Cynthia M. Bulik, PhD, the study's main author and director of the UNC Eating Disorders Program.

"Anorexia is not a good contraceptive," Bulik said. "Just because you're not menstruating, or because you're menstruating irregularly, doesn't mean you're not at risk for becoming pregnant".

Physicians and other health care providers need to be aware of this as well, Bulik said. Doctors who treat women and adolescent girls, in particular, "need to make sure that they have the conversation about sexuality and contraception as clearly with patients with anorexia as they do with all other girls and women".

In addition, providers who take care of pregnant women need to know when their patients have an eating disorder in order to provide appropriate care. Screening for eating disorders during prenatal visits would be an excellent first step, Bulik said.........

Posted by: JoAnn      Read more         Source


November 1, 2010, 7:03 AM CT

Pregnant women who eat peanuts

Pregnant women who eat peanuts
Scientists have observed that allergic infants appears to be at increased risk of peanut allergy if their mothers ingested peanuts during pregnancy. The data are published in the November 1 issue of the Journal of Allergy and Clinical Immunology

Led by Scott H. Sicherer, MD, Professor of Pediatrics, Jaffe Food Allergy Institute at Mount Sinai School of Medicine, scientists at five U.S. study sites reviewed 503 infants aged three to 15 months with likely milk or egg allergies or with significant eczema and positive allergy tests to milk or egg, which are factors linked to an increased risk of peanut allergy. The study infants had no prior diagnosis of peanut allergy. A total of 140 infants had strong sensitivity to peanut based on blood tests, and consumption of peanut during pregnancy was a significant predictor of this test result.

"Scientists in recent years have been uncertain about the role of peanut consumption during pregnancy on the risk of peanut allergy in infants," said Dr. Sicherer. "While our study does not definitively indicate that pregnant women should not eat peanut products during pregnancy, it highlights the need for further research in order make recommendations about dietary restrictions".

In 2000, the American Academy of Pediatrics recommended that women whose infants were at increased risk of allergies based upon family history consider avoiding peanut products while pregnant and breast feeding. However, the recommendation was withdrawn in 2008 due to limited scientific evidence to support it. The Consortium of Food Allergy Research (CoFAR), which was just awarded a renewed $29.9 million grant from the National Institutes of Health, is conducting this ongoing, observational study to help better understand the risk factors behind a child's developing peanut allergy, as well as allergies to milk and egg. The Consortium is also studying novel therapys for food allergies.........

Posted by: JoAnn      Read more         Source


October 27, 2010, 7:03 AM CT

How to deliver breech babies?

How to deliver breech babies?
Most babies are delivered head-first, but in about 4% of all deliveries babies are "born breech" - with their buttocks or feet first. Doctors commonly exercise caution and use caesarean sections (C-sections) as the delivery method of choice for such births, believing it safer for the baby. After a large-scale international study in 2000, C-sections became the near-universal choice for such births.

But now scientists at Tel Aviv University are saying that, under certain circumstances, traditional vaginal delivery for breech babies is not only safe for baby, but even safer for mommy.

Recent studies by a group of researchers including Prof. Marek Glezerman of Tel Aviv University's Sackler Faculty of Medicine and the Rabin Medical Center make this case. Published in major obstetric journals world-wide and presented recently at the Canadian Congress on Breech Delivery, Prof. Glezerman's research indicates that breech babies are no more at risk during vaginal delivery than C-section, and there is reduced morbidity and mortality for the mothers. Based on his findings, Prof. Glezerman is campaigning worldwide for a return to skilled vaginal delivery of breech babies.

The safer way for moms

Caesarean section, explains Prof. Glezerman, is not just another method of delivery. A major surgical procedure, a C-section is not only riskier for a woman and decreases chances she will be able to breastfeed, it also increases maternal risks in future pregnancies. A large number of C-sections are performed because a woman had a breech presentation in the past, he explains - once a woman has delivered by C-section, it becomes more dangerous and occasionally impossible to deliver vaginally, since the uterine walls and muscles are at increased risk for rupture.........

Posted by: Emily      Read more         Source


October 21, 2010, 8:01 AM CT

Conventional, annual Pap smear cost-effective

Conventional, annual Pap smear cost-effective
A study of the options for reducing cancer incidence and mortality among women who have been treated for premalignant cervical lesions observed that an annual conventional Pap smear is a cost effective strategy.

Joy Melnikow, professor in the Department of Family and Community Medicine and his colleagues tested several follow-up screening strategies for the 500,000 American women diagnosed and treated for cervical intraepithelial neoplasia (CIN), abnormal cervical cell growth that can lead to cervical cancer. The first comprehensive study of its kind, "Surveillance After Treatment for Cervical Intraepithelial Neoplasia" would be reported in the recent issue of Obstetrics & Gynecology

"This is a large and growing pool of women who need follow-up after therapy," said Melnikow, who is also director of the UC Davis Center for Healthcare Policy and Research. "But we've had few studies on which to base recommendations for follow-up".

Detection and therapy of these pre-malignant lesions have led to large reductions in cervical cancer incidence and death in a number of countries where screening is routine. But current recommendations about follow-up over time vary widely, and the use of newer technologies had not been fully reviewed until now, Melnikow said.........

Posted by: Emily      Read more         Source


October 18, 2010, 7:51 AM CT

Alcohol during pregnancy

Alcohol during pregnancy
Scientific data continue to indicate that higher intake of alcohol during pregnancy adversely affects the fetus, and could lead to very severe developmental or other problems in the child. However, most recent publications show little or no effects of occasional or light drinking by the mother during pregnancy. The studies also demonstrate how socio-economic, education, and other lifestyle factors of the mother may have large effects on the health of the fetus and child; these must be considered when evaluating the potential effects of alcohol during pregnancy.

A very large population-based observational study from the UK observed that at the age of 5 years, the children of women who reported light (no more than 1-2 units of alcohol per week or per occasion) drinking did not show any evidence of impairment on testing for behavioral and emotional problems or cognitive ability. There was a tendency for the male children of women reporting "heavy/binge" drinking during pregnancy (7 or more units per week or 6 or more units per occasion) to have poorer behavioural scores, but the effects were less clear among female offspring.

A second study, published in Pediatrics, based on a population in Western Australia examined the associations between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects and found similar results, that there was no association between low or moderate prenatal alcohol exposure and birth defects.........

Posted by: Emily      Read more         Source


October 18, 2010, 7:25 AM CT

Genetic test to predict early menopause

Genetic test to predict early menopause
The first research from the Breakthrough Generations Study could lead to a test to predict a woman's reproductive lifespan.

The findings, published recently in Human Molecular Genetics, could have considerable impact on women in the UK and other western countries, where a number of start having children at a later age. Early menopause affects one in 20 UK women.

The study from researchers at the University of Exeter Peninsula Medical School and The Institute of Cancer Research (ICR), funded by The Wellcome Trust, tested four genes linked to the menopause. They compared 2,000 women from the Breakthrough Generations Study who had experienced early menopause with a matched group of the same number. The four genes each affected risk of early menopause. In combination, they had a larger impact, which goes towards explaining why some women experience early menopause.

The Breakthrough Generations Study is a large and comprehensive study into the causes of breast cancer and a partnership between Breakthrough Breast Cancer and the ICR. The study will follow the 100,000 UK women participants for the next 40 years to unravel the lifestyle, environmental and genetic factors that cause the disease.

Eventhough early menopause is linked to a decreased risk of breast cancer, women who experience early menopause are susceptible to other health problems including osteoporosis, cardiovascular disease and a reduction in fertility.........

Posted by: Emily      Read more         Source


October 15, 2010, 7:01 AM CT

Advances against preeclampsia

Advances against preeclampsia
Surendra Sharma, professor of pediatrics
"Hopefully, preeclampsia can be controlled."
In as a number of as 8 percent of pregnancies worldwide, women who seem fine for months develop preeclampsia, a serious complication causing symptoms including high blood pressure, severe swelling, and problems with placental development. The untreatable and unpredictable condition, with no known cause, often requires premature delivery and is sometimes fatal to both mother and fetus.

In a newly released study, scientists led by a team at Brown University and Women & Infants Hospital describe two major advances: a well-defined animal model of preeclampsia and a potential lab test for diagnosing the disease in people.

"Our model is the first pregnancy-specific animal model," said Surendra Sharma, professor of pediatrics at the Warren Alpert Medical School of Brown University and a research scientist at Women & Infants, "and our predictive assay is the first one where we can go back to the first trimester and predict problems".

Sharma is a senior author on the study, published online this month in The American Journal of Pathology. In addition to pediatrics researchers, the study also involved researchers at the Lifespan Center for International Health Research, Harvard Medical School in Boston, and Linkoping University and Helsingborg Hospital in Sweden.........

Posted by: Emily      Read more         Source


October 12, 2010, 7:35 AM CT

Estrogen therapy and kidney stones

Estrogen therapy and kidney stones
Use of estrogen treatment is linked to an increased risk of developing kidney stones in postmenopausal women, as per a report in the October 11 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Nephrolithiasis [kidney stones] is a common condition that affects 5 percent to 7 percent of postmenopausal women in the United States," as per background information in the article. "Because the process of kidney stone formation is influenced by a variety of lifestyle and other health-related factors, the true impact of estrogen treatment on the risk of kidney stone formation is difficult to infer from findings based on observation."

Using data from the national Women's Health Initiative study, Naim M. Maalouf, M.D., of the University of Texas Southwestern Medical Center, Dallas, examined data from two trials: 10,739 postmenopausal women with hysterectomy who received either an estrogen-only therapy or matching placebo and 16,608 postmenopausal women without hysterectomy who received either an estrogen plus progestin therapy or matching placebo. Data were collected for an average of 7.1 years in the estrogen-only trial and 5.6 years for the estrogen plus progestin trial.

A total of 335 cases of kidney stones were published in the active therapy groups, while 284 cases occurred in the placebo groups. The beginning demographic characteristics and risk factors for kidney stones were similar in the two groups, and the authors observed that estrogen treatment was linked to a significant increase in risk of kidney stones. The corresponding annualized incidence rate per 10,000 women per year was 39 in the therapy group and 34 in the placebo group. Development of kidney stones was five times more common in women with a history of kidney stones at the beginning of the study, but was not significantly altered by estrogen treatment. In this trial, estrogen treatment increased the risk of development of kidney stones irrespective of age, ethnicity, body mass index, previous hormone treatment use or use of coffee or thiazide diuretics.........

Posted by: Emily      Read more         Source


October 5, 2010, 7:24 AM CT

Depression during pregnancy

Depression during pregnancy
A nurse's fingertips gently touch the foot of a preterm infant in newborn intensive care. Clinical depression during pregnancy increases the risk of premature birth.

Credit: Clare McLean/UW Medicine

Usage Restrictions: For use by news media and education institutions only.

Clinical depression puts pregnant women at increased risk of delivering prematurely and of giving birth to below-normal weight infants, as per a report published Oct. 4 in the Archives of General Psychiatry.

Being born too soon and weighing too little at birth can jeopardize the immediate survival and long-term health of babies. Preterm birth and low birth weight are leading causes worldwide of infant and early childhood mortality, respiratory distress, neurological and developmental impairment, cerebral palsy, blindness, hearing loss and other disabilities.

Depression is common during pregnancy as well as at other times in a woman's life. Between 9 to 23 percent of women experience clinical depression while pregnant.

"In the United States, the likelihood of experiencing premature birth is even greater for depressed pregnant women living in poverty than for depressed pregnant women from middle- to high-socioeconomic backgrounds," said the main author of the report, Dr. Nancy Grote, University of Washington (UW)research associate professor of social work. Compounding the situation, she added, "Poor women in America are twice as likely to experience depression, in comparison to other women in this country".

Depressed, pregnant women living in European social democracies fared better than poor pregnant, depressed women in developing nations or in the United States, the Oct. 4 paper reported. European women had lower rates of premature births and low-birth weight infants. Social democracies offer universal health care and tend to have fewer socio-economic disparities in birth outcomes. Living in a developing nation or in poverty in the United States, where adequate prenatal, medical and mental health services appears to be lacking, could add to the harmful effects of depression during pregnancy on birth outcomes, the Oct. 4 paper suggested.........

Posted by: Emily      Read more         Source



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Did you know?
The addition of testosterone to hormone therapy in women after menopause enhances their sexual function. However, it may also reduce HDL cholesterol (the "good" cholesterol) in women, according to a systematic review of current evidence."If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern," said Dr. Susan Davis, professor of medicine at Monash University, Melbourne, Australia, and study co-author "However, as an isolated finding the significance is difficult to interpret." She added, "Testosterone has not been found to alter other coronary heart disease risk factors.".

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