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The reason why certain women can get pregnant while taking hormonal contraception
The contraceptive pill is supposed to be 99% effective in preventing pregnancies when taken 'perfectly' (ie, at the same time every day). But despite that, it's not unheard of for women to get pregnant while on the pill.
When taken 'imperfectly' - so, at different times of the day, or with the odd missed pill - that effectiveness rate drops to 91%. Because of this, it was previously assumed that any unwanted pregnancies on the contraceptive pill would be due to the woman not taking it properly.
But new scientific research suggests there might be another cause of unplanned pregnancies occurring despite the pill or other forms of hormonal contraception - and it's one that's beyond your control.
A study carried out by researchers at the University of Colorado Anschutz Medical Campus has identified a particular gene that can break down the hormones commonly found in contraceptive pills and other hormonal contraceptive options, therefore reducing their effectiveness.
The research, which was published this week in the Obstetrics & Gynecology journal, assessed 350 healthy women with a median age of 22.5 years old, all of whom had had the contraceptive implant in place for anywhere between one and three years. Results revealed that 5% of women in the study had a gene called CYP3A7*1C, which tends to exist in foetuses but is usually 'switched off' prior to birth. In a small proportion of women, however, this gene stays with them into adulthood, creating an enzyme in the body called CYP3A7 which is known to break down hormones.
"That enzyme... may put women at a higher risk of pregnancy while using contraceptives, especially lower dose methods," Aaron Lazorwitz, MD, lead author of the study, said.
Lazorwitz suggested the discovery may trigger a change in how doctors treat women with unplanned pregnancies while on contraception.
"When a woman says she got pregnant while on birth control, the assumption was always that it was somehow her fault. But these findings show that we should listen to our patients and consider if there is something in their genes that caused this," Lazorwitz said.
The gene in question is detectable via genetic screening, which the scientist said means that women who are found to have it may in future be able to receive specifically tailored treatment to prevent any further unwanted pregnancies. And that's a pretty important development for us.
Nine major myths about the pill – from cancer to weight gain
For 60 years women were told they needed a break from the pill each month. We now know this advice was wrong, but what else do we misunderstand about oral contraceptives?
Last month, the UK’s Faculty of Sexual and Reproductive Healthcare announced updated guidelines on oral contraceptives, declaring a seven-day break each month to bleed unnecessary. This prompted many women to voice their anger at having been seemingly hoodwinked by ill-advised or ignorant doctors – as well as to wonder what other misinformation about the pill women may have been given in the past 60 years.
Let’s look into the mythology surrounding the pill by answering these common questions.
Why is a break week included in pill packets?
Pharmaceutical companies have usually provided either just 21 pills or seven inactive pills in each monthly packet since the contraceptive first became available. Lisa Hendrickson-Jack describes the reason behind this in her book The Fifth Vital Sign: “The women who participated in the first round of testing for the very first pill, Enovid, stopped getting their periods, and quickly became convinced they were pregnant. They were devastated when they learned the truth – that the pill stopped them from having periods. It was at this point that the creators of the first pill added in a withdrawal bleed.” The idea was that if the pill mimicked the natural cycle, it would encourage more women to use it.
While these so-called “pill bleeds” have always been referred to as “periods” by most medical professionals, they bear no physiological or medical resemblance to menstruation. Women in the 1960s, just like women now, mistakenly believed this withdrawal bleed indicated the absence of pregnancy, and therefore the efficacy of the pill. In fact, you can have a withdrawal bleed and still be pregnant.
Will taking the pill regulate my cycle?
Almost one in three women are reported to be taking the pill on the advice that it will regulate their periods. Again, the bleeds you experience on the pill are not menstruation. The fluctuating hormones, ovulation and menstruation that make up your menstrual cycle are suppressed and replaced by a steady, consistent stream of synthetic hormones (synthetic oestrogen and progestin). The bleeds indicate your body’s response to the withdrawal of these synthetic hormones – a small amount of uterine lining builds up and then comes away. Some women may not experience a bleed at all, or only spotting.
Does the pill affect mood?
Women may have been assured by their doctor that the pill does not affect their mood – or has a positive impact, by preventing symptoms of premenstrual syndrome. In fact, in recent years, two large-scale studies from the University of Copenhagen have revealed that, for users of the combined pill, the likelihood of a diagnosis of depression is increased (by 23%) and, for users of all hormonal contraceptive types, risk of suicide is increasedthreefold. These studies revealed that for teenagers, clinical depression diagnosis is 80% higher and suicide risk doubles after just one year of use. These conclusions have not yet found their way into doctors’ practices, although the researchers argue that women should be warned of the possibility of these side-effects.
The pill is linked to depression – and doctors can no longer ignore itDoes the pill cause cancer?
In her book Beyond the Pill, Dr Jolene Brighten examines the research connecting pill use to cancer diagnosis, concluding: “Breast, cervical, liver and brain cancer risks all increase with the pill. Incidences of uterine, endometrial, ovarian and colorectal cancers are reduced in women who take the pill. I would argue that there are far better ways to prevent cancer that can benefit your entire body and come with much fewer side-effects.” Looking at only the two most common female cancer types, for women who use the pill for a decade or more, a systematic review of 28 scientific studiesrevealed that the risk of cervical cancer doubles; and a study of 1.8 million women revealed an increased breast cancer risk of 38%.
What is the risk for blood clots?
Newer combined oral contraceptives, as well as synthetic-hormone-based devices such as the ring, have a higher risk of blood clots – and the consequent serious or even fatal complications – than older combined oral contraceptives. You may already know that you are at elevated risk on any pill if you are overweight, over 35 or if you smoke – but you are also at far higher risk if you have factor V Leiden, an inherited blood clotting disorder that is considered very common. The risk of death due to blood clots is one in 12,000 for women on the pill, compared with one in 50,000 for non-users – and the risk of hospitalisation is one in 2,000, compared with one in 20,000. As David Rowan details in My Beautiful Memory, a memoir of the death of his daughter, by pharmaceutical companies’ own estimates, this equates to the deaths of about 1,000 women a year in the US alone; it would be approximately 250 women a year in the UK. By comparison, about 250 people have died worldwide taking selfies, and it has made headlines.Is being on the pill like being pregnant?
Women are told the pill “tricks” the body into thinking it is pregnant, and that side-effects (such as weight gain) are similar to those experienced during pregnancy. Lara Briden, author of Period Repair Manual, clarifies: “The pill is not like pregnancy for the simple reason that contraceptive drugs are not pregnancy hormones. In fact, the state of being on the pill is more like a temporary, chemically induced menopause in which hormones are suppressed and replaced with contraceptive drugs that have vastly different effects compared with our own human hormones.”Does the pill affect fertility?
We understand the pill to be a reversible method of contraception – and it is commonly believed that fertility returns rapidly post-pill. However, while some women conceive rapidly post-pill, intentionally or unintentionally, others do not. This can depend on prior reproductive health issues, such as polycystic ovary syndrome, which will return once the pill is stopped.
Maisie Hill, a women’s health practitioner and the author of the forthcoming Period Power, says: “We know from research that women on the pill experience a reduction in ovarian volume and production of AMH – a hormone that’s tested to assess fertility – whilst they’re taking it, so it can take a while for the ovaries to regain function.” There is, she says, “an association between long-term pill use and a thin uterine lining, which is important, because a suboptimal endometrial thickness has a negative impact on your ability to conceive. The pill reduces absorption of vitamins and minerals that are essential for regular ovulation, as well as conceiving and sustaining a pregnancy.”Does the pill make you gain weight?
The correlation between some hormonal contraceptives and weight gain is proven, with the contraceptive injection showing a significant effect; however, the research is conflicting when it comes to the pill. Many women do report gaining weight on the pill, and doctors are actively encouraged to quash such concerns to promote continued pill use. Other known side-effects such as depression may contribute to weight gain.Did I break up with my boyfriend because of the pill?
Women often report feeling a change in attraction to their partner if they go on or off the pill during the course of a relationship. The experience is so widespread that Dr Julie Holland, in her book Moody Bitches, says she recommends that her patients stop taking the pill at least six months before their wedding day. Dr Sarah E Hill, a professor of psychology and author of the forthcoming book This Is Your Brain on Birth Control, agrees there might be a connection: “There is research that finds that going off the pill, if women chose their partners when on it, can lead to undesirable changes in relationship satisfaction. However, a recent attempt to replicate this result failed to find this pattern. The pill may influence women’s relationships with men (and there’s every reason to expect that it will, when we consider the way that sex hormones work), but we need more research to understand the conditions in which this does and does not happen.”
• This article was amended on 25 February 2019 to clarify that a study of 1.8 million women revealed an increased breast cancer risk of 38%, not an overall risk of 38%.
IVF clinics are helping women have babies at 60, despite risks
British IVF clinics are helping women aged up to 55 to have babies – because there is no legal age limit.
One private doctor in the UK said he would even consider helping 60-year-olds give birth.
For years many medical experts have refused IVF for women over 50 using donated eggs from a younger woman to become pregnant.
But there is no cut-off in law, and no guidance from the fertility regulator, leaving clinics free to push the limits. Critics now say they must face stricter rules.
London Women's Clinic is willing to treat women if they give birth by their 55th birthday, while the Glasgow Centre for Reproductive Medicine allows its patients to have a baby at 55.
Dr Marco Gaudoin, GCRM's medical director, said he would consider helping a 60-year-old have a child, adding it was 'sexist' to suggest older women cannot have children when older men can.
British women go through the menopause at an average age of 51 and are at greater risk of miscarriage, stillbirth and having a premature baby if they give birth after this.
Critics point out that children born to a mother in her 50s may have to watch her become ill and die when they themselves are still young.
The Royal College of Obstetricians and Gynaecologists encourages women to have children between the age of 20 and 35.
It's how you feel inside, says UK's oldest mother, 66
Elizabeth Adeney became Britain's oldest mother in 2009 after giving birth to her son aged 66.
The divorcee had fertility treatment in Ukraine, using donor egg and sperm.
She said at the time: 'It's not physical age that is important, it's how I feel inside. Some days I feel 39. Others, I feel 56.'
Mrs Adeney, managing director of a plastics company, first had fertility treatment two decades previously during her short-lived marriage to Robert Adeney.
A source close to Mr Adeney said the marriage foundered because of her all-consuming desire to have a child.
Mrs Adeney had her son Joylon, meaning 'young at heart', by caesarean operation before returning to work four weeks later. She left her baby in care of a nanny at her £600,000 house in Suffolk.
She said what she had done was 'between me, my baby and no one else' and dismissed the fact she had no partner or siblings to help her, saying: 'I'm perfectly capable of looking after myself. I've done it for years.'
In 2016, the last year for which figures are available, 20 women in England and Wales gave birth aged 55 and over. Since 2000, more than 150 have had a child.
Most over-55s use donated eggs from a younger woman because they have none of their own, having gone past the menopause, or have few good-quality eggs.
Susan Bewley, emeritus professor of obstetrics and women's health at King's College London, said: 'Even those who are physically fit or using eggs from a younger woman are still at much greater risk of hospitalisation, stillbirth, having premature babies and pre-eclampsia.
'My concern is the known high maternal death rate and the number of 'near-misses'.
'The IVF industry does not want to put itself out of business. It has always pushed at the limits. This is why it would be sensible for the medical profession to set standards for clinics.'
Dr Nick Macklon, medical director of the London Women's Clinic which treats women with donated eggs up to the age of 54, said: 'Women have been expected to cram all their life tasks into 15 years between the age of 25 and 40, including having a career, finding a man and having children.
Hundreds of thousands demand the PM puts an end to the 'postcode lottery' of NHS IVF treatment, as only 13% of clinics in England offer the standard three attempts
More than 100,000 people have backed a petition calling for an end to the 'postcode lottery' of NHS fertility treatment.
Guidelines recommend that women under 40 should be offered three cycles of IVF, and some aged 40 to 42 should get one cycle.
But the Fertility Network campaign group said this is not mandatory and only about 13 per cent of England's 195 clinical commissioning groups offered the three NHS-funded cycles.
It is urging the Government to create a fairer system so couples across the country get equal access to IVF on the Health Service.
It will present its 102,000-strong petition to Theresa May at Downing Street this afternoon.
'The technology we have opens that up so that they have longer. We believe an age limit for them to deliver at 54 is reasonable.'
The private clinic has accepted 26 women aged 51 to 54 for egg donation treatment in the three years its policy has been in place.
Dr Macklon said: 'Women over 50 are asked to confirm with an obstetrician that they are fit and healthy for pregnancy, while their medical and social circumstances are assessed from a child welfare point of view.'
Dr Gaudoin said: 'There is a sexist element in saying women cannot have children in their 50s, when men can do so in their 70s and 80s. There is a 'yuck factor' and these prejudices should be challenged.'
His clinic's age of 55 for women using donor eggs was set by its ethics committee. But it is not a 'blanket limit' and Dr Gaudoin said he would consider treating a woman aged 60 if she were mentally and physically well, before asking the committee to consider the request as well.
Dr Gaudoin said: 'We take a thorough medical and family history of these women and also ask their GP how they feel they and their partners will cope.'
For there to be an age limit for IVF using donated eggs, the law would have to change. The Department of Health could do this, if there was enough pressure and evidence of bad practice.
Regulator the Human Fertilisation and Embryology Authority has the power to set guidance telling clinics not to exceed a certain age, but has not done so.
The HFEA and the Department of Health stressed that clinics are obliged to consider both the patient's circumstances and the best interests of any resulting child before proceeding.
Dec 22nd 2018
Signs you might be pregnant (other than a missed period)
Your body will slowly but surely start to change if you’re pregnant, and there may be a few signs you notice before you even think about taking a test.
Although every woman is different, a late period is often the first clear sign. But light vaginal bleeding (spotting) is relatively common during the first three months of pregnancy, so even this can be possible to miss.
If you think you might be pregnant, your best bet is to buy a test and find out for sure. But if you’re frantically Googling in your bathroom (we’ve all been there...), we’ve rounded up the symptoms it’s worth being aware of.
Most women also have other early signs of being pregnant, in addition to their periods stopping, according to the NCT. These include:
Feeling nauseous or actually vomiting is very common in early pregnancy. Despite being colloquially known as “morning sickness” it can occur at any time of the day, so don’t discount evening sickness as food poisoning. The good news is it usually stops by weeks 16-20 of your pregnancy. Severe pregnancy sickness is called hyperemesis gravidarum and you should speak to your GP or midwife if you think you might be affected.
Changes in your breasts
Hormones will start to prepare your body for breastfeeding if you’re pregnant. You may notice tenderness, a tingling sensation and that they feel larger than usual. Some women also find their nipples appear darker and seem to stand out more than usual.
Changes to your toilet habits
It’s likely you’ll feel the urge to urinate more frequently if you’re pregnant. This tends to kick in within the first few weeks, and often continues for the whole nine months (joy). Constipation is also likely.
A metallic taste in your mouth
This one may sound usual, but it’s actually quite common, according to the NCT.“You may also notice smells and tastes more strongly, as well as developing an aversion for foods you used to like, or equally, start enjoying foods you used to dislike,” the site explains, adding that there’s no formal explanation.
Other symptoms can include tiredness, a change in vaginal discharge and mood swings.
If you think you’re pregnant, the NHS advises seeing a healthcare professional as soon as possible, even if you haven’t taken a pregnancy test yet.
You can buy a pregnancy test in the majority of pharmacies or supermarkets and the following places provide them for free:
· Brook centres (for under-25s)
· Some GP surgeries
Dec 12th 2018
One set of twins – two fathers: how common is superfecundation
Constance Wu, of Crazy Rich Asians, is in talks to star in a new romcom. Apparently, her character is a bit ditzy – a classic romcom trope. But this ditziness will lead to what I am fairly sure will become a new romcom trope: heteropaternal superfecundation.
“It does sound a bit Mary Poppins,” says Michael Carroll, a reproductive scientist at Manchester Metropolitan University and the father of identical twin boys. He explains that heteropaternal superfecundation occurs when a woman gives birth to twins with different biological fathers. Once you can get past all the polysyllables, the romcom possibilities are endless: mistaken identity, twins who look comically different (see Arnold Schwarzenegger and Danny DeVito in Twins), competing suitors.
Although rare in humans, heteropaternal superfecundation is common in dogs, cats and cows, Carroll explains. “Females will have multiple matings with multiple males and this increases the chance of them producing multiple offspring.” Humans, on the other hand, “are not the best at breeding”. That is one way to look at it. So how does superfecundation with multiple fathers happen at all?
There are two ways through intercourse, according to Jason Kasraie, the chair of the Association of Clinical Embryologists. First, a woman can release two eggs at the same time. Since sperm can survive for a few days in the female reproductive tract, loitering in the corner of the womb and the fallopian tube, it would be possible to have sex with one father-to-be in advance of the egg being released, and another just after ovulation.
In the second scenario, the woman releases two eggs a few days apart but in the same reproductive cycle.
Either way, “It’s extremely uncommon,” Carroll says. “It all adds up to many rarities happening in the same cycle.” A sperm’s journey is arduous at the best of times. To have two successful candidates from two different men in a month when two eggs happen to be released … Well, what are the odds?
Kasraie has found two studies of the incidence of heteropaternal superfecundation, both from the early 1990s. One author claims that one in 400 pairs of fraternal twins (those arising from two eggs) fits the description. The second author puts the figure at one in 13,000 cases of paternity. These sound like best guesses. “They do,” Kasraie agrees. He points out that we cannot know the true number, and research has been scant. Most cases come to light only when paternity is questioned and a DNA test carried out. Apologies if this turns out to be a spoiler.
Dec 6th 2018
This womb transplant breakthrough could open up pregnancy to all sexes
The live birth of a baby girl in São Paulo is a medical advance that may change the definition of motherhood
year ago, a baby girl was born by caesarean section in a hospital in São Paulo, Brazil, after being conceived by IVF. What made the birth unique was that the child had been gestated in a womb transplanted from a 45-year-old woman who had died.
Births resulting from uterus transplants have been happening since 2014, but for all previous children conceived this way, the donor was alive. That, understandably, places severe limits on the availability of the organs. This demonstration, reported in the Lancet – that a uterus can be successfully preserved and transplanted from a deceased person – could relax the supply bottleneck for women otherwise unable to conceive because of uterine problems.
The recipient in this case was a 32-year-old born with a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. It affects one in 4,500 women and means that the womb fails to develop. Before she was given the transplant in 2016 it was unclear if a uterus could remain capable of gestating a baby if it had been deprived of blood supply for some time after the death of the donor. The baby weighed 2.5kg at birth on 15 December 2017, and both mother and child remain healthy. The transplanted uterus was removed from the mother during the delivery.
All this sounds like good news for women who, because of injury, illness, surgery (hysterectomy) or congenital conditions, would need a transplant in order to bear a child.
But not everyone will see it as an unqualified good. Since the first uterine transplants, opinion has been split about their merits. Some bioethicists point to risks of complications for the recipient and the foetus, as well as the high cost. Some question whether these drawbacks are outweighed by the benefits when the alternative of surrogacy exists – although that of course has its own problems, and it would be naive to draw an equivalence between them.
But uterus transplants also raise complicated questions for feminism. “There is a feminist position that supports the uterus transplant, arguing that it allows women … to be included in an experience that is, for some, central to and defining of femaleness,” wrote body theorist Sharrona Pearl. But, she added, that is part of the problem: “The uterus transplant supports the social norm of pregnancy as fundamental to being a woman.” Uterus transplants imply that the risks of the procedure are worth it, says Pearl, “in order to fulfil women’s alleged biological destiny as carriers of future children”.
This tension is nothing new. Ever since the early discussions of assisted reproductive technologies (ART) such as IVF in the 1920s, they have split opinion about the implications for gender roles and female choices in particular. The idea promoted then by biologists such as JBS Haldane of gestation in artificial wombs – ectogenesis – was welcomed by progressives as an emancipating technology that would free women from the duties of childbearing and the associated constraints on opportunity.
In the 1970s, Shulamith Firestone, author of The Dialectic of Sex, was an enthusiastic advocate of ectogenesis for those reasons, saying that only by being relieved of responsibility for childbearing could women hope for social equality. To Firestone, pregnancy was “barbaric” and tyrannical. Others feared that an artificial womb (which remains beyond the means of today’s technology) would sever the mother-child bond and deprive women of their role. “If that last power is taken and controlled by men,” wrote sociologist Robyn Rowland, “what role is envisaged for women in the new world?”
IVF itself has elicited similar concerns. For all that it offers some women their only chance of pregnancy and childbirth, it can seem too much like the commodification of a woman’s body by a male-dominated techno-elite. In the mid-1980s, the German radical feminist group Rote Zora bombed IVF clinics and stole documents, while the feminist network FINRRAGE (Feminist International Network of Resistance to Reproductive and Genetic Engineering) has long expressed scepticism about assisted reproductive technology from feminist and socialist perspectives.
There’s a danger, as with objections to uterus transplants, that, as social historian Naomi Pfeffer has charged, the critics consult the views of all women except those who actually suffer from infertility. But it’s quite right that advances in ART be interrogated as much more than neutral medical options.
By making pregnancy potentially available to trans women and even to cis men (with hormone treatments), uterus transplants could challenge social norms and preconceptions, just as IVF has done by creating new family structures. But equally, by insisting on a particular route to motherhood these transplants could reinforce those norms and stereotypes, just as anthropologist Sarah Franklin has argued that anxieties about IVF have motivated social conformity in the way it is presented and practiced.
As a man, I know I will be sensitive to only a fraction of these currents. But I hope they can be discussed frankly, tolerantly and with compassion. Few issues are more emotive than conception and child-rearing – but that’s precisely because there are no easy answers.
• Philip Ball is a science writer
Oct 20th 2018
The early menopause explained
One in 100 women will go through the menopause before the age of 40.
Concerned you may have hit the early menopause? Here's the lowdown on everything you need to know:
What is the menopause?
Our ovaries produce the hormones oestrogen and progesterone, which are needed to regulate our monthly cycle and ensure the development and implantation of a healthy egg. For the majority of women, the average age of the menopause is 51, and occurs as a result of the ovaries running out of developing eggs (follicles).
What is the early menopause?
In the early menopause, the ovaries stop producing normal levels of oestrogen. There are a number of explanations for this, it may be due to a reduced number of follicles at birth, or an increased rate at which these follicles are destroyed, or simply that they do not function as well.
This is more common than one might expect and affects about one in 100 women before the age of 40 and one in 20 women before the age of 45. During your own research you may also read the terms premature menopause, or primary ovarian failure, but these are essentially all interchangeable with the term early menopause.
What are early menopause symptoms?
For most women the first symptoms of the early menopause will be a change to your menstrual cycle, with either fewer, or no periods. But, many will also get the other symptoms associated with the normal menopause including:
· Hot flushes
· Night sweats
· Mood changes
· Change in libido
If you are having any of these symptoms we can test for the early menopause with a blood test, looking for the levels of the hormone oestrodiol (oestrogen), which will be low in early menopause, and for the hormone Follicle Stimulating Hormone (FSH.)
FSH is raised in the early menopause as the pituitary gland in your brain releases increasing amounts in a bid stimulate your ovaries to try and produce more oestrodiol. These tests need to be done at certain times in your cycle and repeated again at least 4 weeks later to confirm the diagnosis.Why does the early menopause occur?
Early menopause can be as a result of the damaging effects of chemotherapy and radiotherapy, or if the ovaries are removed during an operation. Occasionally it is due to chromosomal or genetic problems, or as a result of autoimmune diseases such as diabetes or thyroid disease.
If you are diagnosed with early menopause, further blood tests will be done to look for these underlying causes, though chromosomal testing is only done if you are under 35.
Knowing when your mother started her menopause may give you a clue into when you may start your own, but in most cases we do not know exactly why the early menopause happens. Interestingly it has been found that cigarette smokers are at increased risk of premature menopause. Conversely, starting your period later in life, having irregular periods and breast-feeding for longer are all protective factors against early menopause.Are there early menopause complications?
Due to the reduction in oestrogen, women with the early menopause have been found to have a significantly increased risk of osteoporosis (bone thinning), cardiovascular disease and possibly dementia. It is worth noting that while there are considerable complications of the early menopause, it does decrease the risks of the oestrogen-sensitive cancers like breast cancer.Can I still get pregnant?
Women with the early menopause will have fluctuations in their ovarian function and will not ovulate (release an egg) every month, but some may still ovulate occasionally. Indeed, it has been found that 5–10% will become pregnant over their lifetime. It is therefore really important that even if you have been diagnosed with early menopause you continue to use contraception if you want to avoid falling pregnant.
The added oestrogen in the combined contraceptive pill may also help protect against osteoporosis and cardiovascular disease. If, however you are hoping for a pregnancy, the pill is not appropriate, and you should be looking into other ways to protect against the risks of low oestrogen levels. Consult a fertility specialist early, as often egg donation is required.Is there early menopause treatment?
There is no way of reversing the early menopause, but we can treat the symptoms and try to protect against the long-term complications associated with it. Whilst the contraceptive pill can be used as a treatment in women who want to protect against pregnancy, there are some concerns about the long-term risks of the pill and its effectiveness against osteoporosis. Hormone Replacement Therapy (HRT) will not only improve the symptoms, but also reduce the risk of osteoporosis and cardiovascular disease.
Experts agree that to reduce your risks of cardiovascular disease and osteoporosis, lifestyle and dietary intervention has to be taken as well. Reassuringly the same risk of breast cancer from HRT that we are often concerned about in treating women going through the menopause, does not apply to women under the age of 50. However a woman taking HRT for early menopause should be reviewed at the average of the normal menopause, as the risk/benefit ratio will change at this point.Menopause support
The early menopause can be something that can be difficult for people to come to terms with. The impact of early menopause is not just physical; counsellors and therapists are there to help with the anxiety or low moods many experience. Finally, there are support groups out there; talking to other women going through the same experience cannot be underestimated.
For advice and guidance, try one of the following:
Oct 5th 2018
Pregnant women can FINALLY get a prescription for morning sickness: Four times a day pill is licensed for use in the UK
Hundreds of thousands of pregnant women in the UK can now be prescribed a pill licensed for morning sickness for the first time in decades.
Xonvea is the first pill of its kind to specifically tackle nausea and vomiting during pregnancy (NVP) since Debendox was withdrawn in the 1980s.
The drug has been used for years in the US and Canada – but wasn’t licensed for pregnant women in the UK to take until this summer.
Xonvea has only been launched by a drug firm in the UK today. Pregnant women with NVP are recommended to take between two and four pills a day.
For years expectant mothers battling morning sickness in the UK have relied on general anti-sickness drugs to combat their symptoms
Several trials on pregnant women have shown Xonvea is around 23 per cent better than placebos at stopping symptoms of morning sickness.
It could be used by women who have already tried changing their diet and lifestyle to avoid sickness but still need medical help.
The British Pregnant Advisory Service said it hoped Xonvea would help reduce the number of women whose morning sickness is so bad they have an abortion.
Up to 80 per cent of all pregnant women suffer from NVP, which amounts to around 690,000 women in England and Wales.
Oct 3rd 2018
Abortion outrage: Mums should be allowed to terminate newborns, say Australian academics
KILLING newborn babies should be allowed if the mother wishes,
Australian philosophers have argued in a prestigious journal.
Their argument, that it is morally the same as abortion, has forced the British Medical Journal to defend its publication of their views.
In an article that has sparked outrage around the world and elicited death threats, Monash and Melbourne University academics argue that a foetus and a newborn both lack a sense of life and aspiration.
They argue this justifies “after-birth abortion” on the proviso it is painless as the baby is not missing out on a life it cannot contemplate.
The doctors of philosophy argue in the BMJ publication Journal of Medical Ethics that one-third of infants with Down syndrome are not diagnosed in the womb, which means mothers of children with severe disabilities should have the chance to end a child’s life after, as well as before, birth.
However, the pair also want the principle of killing newborns extended to healthy babies, because a mother who is unwilling to care for it outweighs an infant’s right to life.
In the article, After-birth abortion: why should the baby live?, the authors argue: “A serious philosophical problem arises when the same conditions that would have justified abortion become known after birth. In such cases, we need to assess facts in order to decide whether the same arguments that apply to killing a human fetus can also be consistently applied to killing a newborn human.”
They also write that the practice should be called “after-birth abortion” and not “infanticide” to “emphasise that the moral status of the individual killed is comparable with that of a foetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child”.
“We claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia.”
Although the authors claim that the “moral status of an infant is equivalent to that of a fetus, that is, neither can be considered a ‘person’ in a morally relevant sense”, they concede it is hard to exactly determine when a subject starts or ceases to be a “person”.
The editor of the Journal of Medical Ethics, Julian Savulescu, said the article had “elicited personally abusive correspondence to the authors, threatening their lives and personal safety”. He said some of comments included:
These people are evil. Pure evil. That they feel safe in putting their twisted thoughts into words reveals how far we have fallen as a society.”
“Right now I think these two devils in human skin need to be delivered for immediate execution under their code of ‘after birth abortions’ they want to commit murder – that is all it is! MURDER!!!”
“The fact that the Journal of Medical Ethics published this outrageous and immoral piece of work is even scarier”
“Alberto Giubilini looks like a muslim so I have to agree with him that all muslims should have been aborted. If abortion fails, no life at birth – just like he wants.”
He defended the article, saying the arguments in the paper were not new. “The novel contribution of this paper is not an argument in favour of infanticide … but rather their application in consideration of maternal and family interests. The paper also draws attention to the fact that infanticide is practised in the Netherlands.”
He said that “more than ever, proper academic discussion and freedom are under threat from fanatics opposed to the very values of a liberal society”.
Sept 28th 2018
Sexual Health Week: Why are millennial women rejecting the pill?
In 1961, the contraceptive pill was launched in the UK, changing sexual health forever. Nearly 60 years later and there’s an array of options available to women who want to have control over their lives, futures and relationships.
Ten years ago, nearly half of women using Sexual Health and Reproductive Services were swallowing a tablet each day, with the second most popular protection option being male condoms. Today, both numbers have decreased and various studies have shown that millennial women are seeking alternatives to the sexual miracle of the Sixties.
In 2018, use of the implant has now overtaken the male condom and is fast catching up to the pill, while the number of women choosing to use Long-acting Reversible Contraception (LARCs) has nearly doubled since 2008. But why are women today opting for implants, injections and coils over their previously popular counterparts?
Forty-four per cent of women still take the pill each day in England but there have been growing concerns over its links to depression and, more generally, the side effects of hormonal contraception.
Frankie Wells is one half of Project Pleasure, a podcast which discusses women’s sexual health and relationships. She started taking the pill at 17. “As a teenager first taking the pill, I had no understanding why I had this sudden wave of anxiety and paranoia, which led me to feel extremely isolated right through to my early 20s,” she explains.
For years, the 26-year-old battled negative feelings while fearing judgement. It was only when Wells stopped taking the pill that she stopped experiencing such anxiety: “Coming off the pill I had this new found confidence in who I was and how I felt.”
Sexual health charity, the Family Planning Association insists that despite zero evidence of a causal link between the pill and depression, “women’s experiences must still be acknowledged and taken seriously”. Side effects of the pill have been known to cause mood swings, headaches and issues with blood pressure, while a 2016 study did find that users were more likely to take antidepressants.
Starting on the pill at 16, these side effects were just some of the reasons contraception blogger Rio Muzzall decided to come off hormonal birth control entirely. At the time, she was given very little information about the pill: “All I was told was that if I had any negative side effects, they would subside after a few months.”
Seven years later and Rio’s health was suffering; experiencing digestive issues, anxiety, high blood pressure and frequent bleeding, the 26-year-old was advised to start taking more medication to tackle her problems. “As a 23-year-old, having to take blood pressure medication did not sit well with me,” she explains.
“I felt I had no choice but to take my health into my own hands. I wasn’t prepared to risk worsening my health further by trying other hormonal methods.”
Distrust of hormones has led to many women seeking alternatives: condoms, caps and diaphragms provide hormone-free barrier protection during sex. For longer term protection, the copper coil is popular with millennials.
More than 99 per cent effective, the copper coil, or IUD, provides protection against pregnancy for up to 10 years. Dr Anita Mitra blogs about sexual health, she’s seen the increased demand for hormone-free contraception first-hand: “I am seeing so many people wanting the copper coil, it’s like the new black of contraception – everyone wants it!”
“Honestly, I think it’s because of the whole chat on social media about ‘all-natural, no hormones’. The problem is, I’ve removed a lot of copper coils because people are like, ‘oh my God, I’m having this torrential period every month’ because it does make your periods heavier,” she explains.
Like most birth control, the copper coil comes with its own side effects and has been shown to make periods heavier and longer. Dr Mitra says the most common reasonpeople choose to have the IUD removed before its expiry date is because of bleeding. She insists that there are many myths surrounding hormone-based contraception and it shouldn’t be dismissed so quickly.
“The hormones in contraception are basically mimicking what your body would do on a normal basis,” she explains. “There’s not really any strong evidence to show that that causes any harm; it doesn’t damage your fertility.”
A wave of wellness trends have vilified hormonal birth control, leading to natural family planning methods gaining status. While these methods have no side effects and can be used by women wanting to avoid pregnancy or start a family, accuracy is crucial but not always guaranteed when monitoring basal temperatures and signs of fertility.
Infamous app Natural Cycles is currently under investigation in Sweden after hospital records revealed 37 patients using it as birth control had fallen pregnant between September and December 2017. The Advertising Standards Agency also banned its adverts from Facebook this year, deeming claims that it’s a “highly accurate” contraceptive to be misleading.
However this isn’t to say that choosing hormone-free contraception hasn’t helped many people or isn’t effective. For Rio, it “felt like a black cloud had been lifted” when she stopped taking the pill and she continues to use the Fertility Awareness Method, describing it as “empowering experience” bringing her and her fiancé closer.
A lack of sexual health information when young has left many women only finding alternative birth control methods later in life, often learning from peer experiences and advice.
This insufficiency appears to be a common issue for young women – something that the Family Planning Association recognises. “A 10 minute appointment with a GP is not enough time to talk through your options in any great deal,” explains Deputy Chief Executive, Bekki Burbidge. While “relationships and sex education in schools is variable and might not cover contraceptive choices in enough detail”.
Dr Mitra agrees: “There isn’t a lot of awareness that there is something else out there because education about contraception just isn’t that great.”
Whether it’s constantly forgetting to take it at the same time every day, feeling you were rushed into it at a young age because you weren’t made aware of any other options or just wanting something more long-term – there’s a multitude of reasons why women are seeking alternatives to the pill.
Fellow Project Pleasure podcaster Anouszka Tate wishes she had known more about her options when she started taking the pill at 15: “I’m frustrated for my younger self, that I wasn’t aware of the side effects because at least I would have been able to analyse the potential reasons behind the changes I was seeing in my body and life.”
That’s why education is critical when it comes to birth control – from knowing what’s available and best-suited to you, to not shaming others for their birth control choices. Dr Mitra believes that “contraception is a personalised thing,” that has to be “a one-on-one conversation because you are an individual”.
Sept 11th 2018
Pippa Middleton reveals how she stays fit during pregnancy
Soon after she announced that she is expecting her first child with James Matthews, Pippa Middleton revealed how she had been keeping fit during pregnancy and offered tips for other mothers-to-be. Now with the baby's arrival reportedly just over a month away, the 35-year-old has shared how she has adapted her exercise regime to maintain a healthy lifestyle and improve her posture.
In her recent column for Waitrose Weekend, Middleton, who turned 35 on Thursday, wrote (via Hello!): "I feel far from a ballerina, but I'm equally determined not to break into a penguin-style waddle and plod around with bad posture.
"So with this in mind, I've continued to embrace
barre-inspired workouts throughout pregnancy - a form of exercise taken from
ballet which involves the small, isolated movements that develop flattering
muscle tone - or so I hope."
Barre, a low-impact form of strength training, incorporates movements derived from ballet, yoga and Pilates. As well as toning muscles, it has also been credited with improving alignment - and it's not the only workout Middleton has spoken candidly about.
Earlier in the summer, Middleton shared how she was keen to continue playing tennis and outlined the positive effects of playing the sport during pregnancy. In a previous column, she described the health advantages as: "improved placental growth, good weight management, as well as reducing back pain, strengthening heart and blood vessels, overall body strength, and reducing the risk of gestational diabetes."
As well as barre and tennis, the mum-to-be has also written about enjoying swimming and its "wonderful feeling of weightlessness".
Rumours that Middleton and her husband Matthews were expecting their first child first emerged back in April shortly before the Duchess of Cambridge welcomed her third child, Prince Louis. They have not announced when their baby is due, although it's reported to be a date in October.
Sept 5th 2018
'Seven things I learnt about my mental health while pregnant'
Pregnancy books often act like the beginning of the book equals the beginning of your life. As if there was no you before you got pregnant.
Of course, you’re not pregnant in isolation. You’re pregnant in the midst of all the chaos that already constitutes your life, alongside the experiences you’ve carried with you from your past.
My life when I saw 'pregnant' on my test (I used a fancy digital one to be doubly sure) was stable-ish at best. I have a borderline personality diagnosis paired with a history of self-harm and a combination of anxiety and depression that follow me around like stray dogs. Finding out I was pregnant was joy sandwiched in between "oh s**t" and "how will I do this?"
’m 36 weeks at the time of writing this, counting down until I get to meet the person that’s been wreaking havoc on my uterus. Pregnancy has been a rollercoaster. I’ve dry-heaved more times than I care to think about. My pelvis has turned to mush and my breasts look like bruised watermelons fallen from the back of a truck.Then there’s my mental health, which has been through bouts of balance and clarity and episodes of terrifying lows and darkness.
On the plus side, I have learnt an awful lot - from knowing when to ask for help, to finding out how my pre-existing mental health conditions affected my pregnant, hormonal brain. Here are some of my big takeaways:
1. Learn to let go
My biggest enemy, and one that I’m sure I’ll face many times throughout motherhood, is my own idea of what a mum should be like. My perfect mother image is someone who has their life completely ironed out; a stable job, perhaps a nice garden, a car, goes to yoga a lot, has lots of other mum friends and - above all - has a nice, calm balanced brain.
I used my perfect mother image as a tool to beat myself up with. What I learnt from speaking to other mothers is that you don’t have to be perfect. You don’t have to have it all figured out.
My idea of what a mum has to be like is just that: an idea. It’s not based on anything other than a standard I’ve set for myself. When you shake it off, just like we shake off oppressive beauty ideals and labels, you give yourself the room to just be.
2. Don’t forget about yourself
In the beginning of pregnancy, with miscarriage fears looming round every corner, my only concern was making sure the baby was OK and that I wasn’t messing anything up.
However, it’s easy to forget that you need to be OK too. For me this played out in my medication. Initially my GP decided to lower the medication I’d been for my depression. I obliged, it seemed like the right thing to do and I didn’t want to harm the baby.
When my mental health started to do a slow swan dive into a negative spiral my midwife told me that there was no reason for me to lower my dosage. The chances of it affecting the baby were really small and that a relapse into depression would be more detrimental to the pregnancy than if I stayed medicated. It was one of those moments where I forced to put myself first. I needed to keep everything in balance, for me, and then I could be better for the baby.
3.Don’t pile the pressure on
There’s a lot to sort out when you find out you’re pregnant and it can feel like you’re standing at the bottom of Mount Everest. I felt like there was no way I was going to sort out my finances, living situation, diet or mental health in time for the baby’s arrival.
What ended up helping was breaking things down into weekly chunks and if that got too much, breaking things down into small daily tasks, which could be anything from booking a parenting class to eating some spinach. Nine months is actually a lot longer than you think. Plus, your life doesn’t have to be baby proof the second your baby gets there. You can be a work in progress.
4.Talk to the professionals
Your midwife isn’t just there to check on your baby’s health; they want to know how you are doing both physically and mentally as well. When I encountered a scary mental health dip, the midwife was the first to know, and she arranged for me to check in with the psychiatrist and get my medication looked at.
I also went to see a perinatal mental health nurse who focussed on preparing me for labour and the immediate weeks after. I see a community nurse who informs me about services and groups I can attend in my local area. In short, there’s loads of people willing to help you just have to be honest with them.
5.Seek a community
A month ago I enrolled my boyfriend and I in a parenting class and lots of people told me this was when I was going to make "friends for life". Walking to the class on a Saturday morning felt like walking into school on the first day. I dug my heels into a crack in the pavement and told my boyfriend there was no way I was going in: "I don’t want to meet people. Don’t make me go in there!"
He reminded me that we had paid a fortune for these classes and that magically trumped my social anxiety, so in we went. I met a few people I liked but no one I imagined being best friends for life with. I wondered if I should’ve tried harder, if I’d been a little too introverted?
I’ve recently started to relax about this idea of finding a 'mum squad'. I’m hoping it’ll just happen naturally by taking part in things in my area. Meanwhile I’ve been part of three different Facebook groups for all things pregnancy. One is an offshoot of a podcast I listen to called the The Lady Gang. Most of the women in the group live in America so it’s not like I’ll be able to invite them round for tea any time soon, however I’ve been in almost daily communication with the group. I’ve told them about mental health concerns, funky looking discharge, financial worries, cramping, spotting, leaking breasts, falling asleep at work etc etc. Yes they might not be 'IRL' friendships but having a tribe of women who are totally non-judgemental and just want to share experiences has been a godsend.
6.Take time to get to know your body
I struggled a lot with body image as a teen and the only way around it for me was to pretty much become apathetic towards my body. Instead of body positive, I was body neutral: "Yeah, I weigh this much, my skin is like this, my hair does this, whatever". I’ve been lucky enough to never have to go through any radical changes physically so I didn’t have to adjust my attitude.
Then I got pregnant. The physical changes started coming at me faster than puberty. It was easy to look in the mirror and think: "HOLY HELL WHAT IS THAT!" but instead I tried to make a mental captain’s log: what’s happening and why? I reminded myself that my body is like a house, keeping my baby safe. My bugle-y leaky breasts are practicing to feed. The hair that sprouted over my belly is there to keep her warm. My expanding stomach is packed full of protective layers. My body is serving a function, and when you think about it, it’s pretty awesome.
7.Remember some things are "just" pregnancy things
From having to be so aware of my mental health since I was 16, I’m hypersensitive to any changes in my reactions, behaviour or feelings in the hope to detect a depressive episode before it takes hold completely.
In pregnancy, you have a gaggle of hormones surging through your body at different times, messing with your head. I had a particular irrational outburst outside of a Swedish bakery in a shopping mall in West London last month after finding out they’d run out of cinnamon rolls. I sat on the floor outside the bakery and had to get my boyfriend to pick me up. I was like an angry toddler, furious that they hadn’t stocked enough of the pastries I’d been thinking about all day. The nerve!
One of the women I’d spoken to in my parenting class, who seemed like the calmest, most chilled-out person in the room, told me about the time she went out for dinner and they’d burnt her pizza. She took the pizza from her table, walked right into the kitchen, sat down on the tiles and said: "Why are you doing this to me???" (Note how both our outbursts involve food and sitting down.)
I learnt throughout pregnancy that not everything is a sign that my mental instability is flaring up. Some things are just the result of being pregnant. Pregnancy isn’t the easiest thing in the world; it’s good to acknowledge that at times it can be hard and can take a real toll on your emotions. It’s not an easy feat.
Sept 4th 2018
Children born through IVF face 'higher risk of cardiovascular disease'
Children conceived through IVF and other forms of assisted reproduction are more likely to suffer from cardiovascular diseases which can have life-long health effects, Swiss researchers have found.
A study published on Monday claims to be the first evidence that IVF has a long-term impact and teens born via assisted reproduction were six times more likely to have clinically high blood pressure as those conceived naturally.
The researchers, from the University Hospital in Bern, say this may be down to the unmeasured impact of the techniques which see sperm and egg stored in an artificial medium and manipulated to form an embryo.
This study was small, with fewer than 100 subjects, but it follows data from animal tests which found blood vessels and heart abnormalities were more common with mice born through IVF, and has sparked calls for much larger safety trials.
“There is growing evidence that artificial reproduction techniques (ART) alters the blood vessels in children, but the long-term consequences were not known,” said Dr EmrushRexhaj, a blood pressure expert and lead author of the study.
“We now know that this places children [born through artificial reproduction] at a six times higher rate of hypertension (high blood pressure) than children conceived naturally.”
Dr Rexhaj told The Independent: “This is the first demonstration of increased prevalence of a cardiovascular disease [in children conceived through IVF].”
But he said a 2014 study has suggested these patients may also be more at risk of Type 2 diabetes, adding: “There is already evidence showing insulin resistance in this population.”
Larger trials would be needed to conclusively show a health risk, experts say this should be considered urgently as the population born through IVF and other techniques is growing rapidly with the earliest births now in middle age.
There are an estimated six million people alive who were conceived with artificial reproduction techniques worldwide and in July, Louise Brown, the first child born through the IVF, celebrated her 40th birthday.
For the study, published in the Journal of the American College of Cardiology on Monday, Dr Rexhaj recruited 97 healthy young people with an average age of 16 – 54 of the subjects were born through IVF.
The team monitored their blood pressure over 24 hours and looked at other health measures including the stiffness of their blood vessels and traits like body-mass index and smoking.
Children born through ART had higher blood pressure overall and eight of the children in this group were above thresholds for clinical hypertension, compared to one of the 43 control participants.
Looking at their health records five years before the study, they found no discernible differences between the groups.
Experts said factors which led to parent’s infertility – such as being older or pre-existing health conditions – and lifestyle traits could also be responsible for some of these differences.
Professor Robert Norman, a reproductive medicine expert at the University of Adelaide said: “It warrants a much larger study of the hundreds of thousands of IVF-conceived children in Australia who up until now have shown few medical consequences as a result of their conception.”
He added: “It may be that the first few days of exposure of an embryo to artificial culture media may affect a number of developing organs, including the heart and blood vessels.”
Professor Alastair Sutcliffe, professor of general paediatrics at University College London is leading a major study on the long-term impacts of IVF using data from 77,000 patients in England and Wales, and said all the studies too data have been too small to separate risks from the impact of lifestyle factors.
He added. “IVF conceived individuals are generally healthy but at higher risk of Beckwith Weidmann Syndrome diagnosed at birth and also at higher risk of diseases associated with prematurity if born premature.
“Otherwise their health to date – for example with cancer risk – is no different than the population as a whole.”
Aug 21st 2018
More Women Are Using Pot During Pregnancy. Here's One Reason Why.
It's becoming more common for pregnant women to use pot in pregnancy, and a new study suggests one reason for the trend: Some pregnant women may be using marijuana to self-medicate symptoms of morning sickness.
The researchers found that pregnant women with severe nausea and vomiting in their first trimester had nearly four times greater odds of using marijuana in pregnancy, compared with pregnant women who didn't experience morning sickness. And women with mild nausea and vomiting in pregnancy had two times greater odds of using marijuana, compared with women who didn't have these symptoms. [The 11 Strangest Pregnancy Trends]
The findings add to "a small but growing body of research suggesting that some pregnant women may use marijuana to self-medicate morning sickness," lead study author Kelly Young-Wolff, a research scientist at the Kaiser Permanente Division of Research in northern California, said in a statement.
Marijuana and morning sickness
In recent years, the percentage of pregnant women who report using marijuana has increased, from about 2.4 percent in 2002 to nearly 4 percent in 2014, according to a 2017 study. However, the reason behind the rise is unclear, and one hypothesis is that pregnant women are using marijuana to treat symptoms of morning sickness. However, few studies have looked at the link between marijuana use in pregnancy and symptoms of morning sickness.
In the new study, the researchers analyzed information from more than 220,000 pregnant women in northern California. These women filled out a survey about their substance use and provided urine samples in their first trimester for drug screening. The researchers also examined the participants' medical records, looking for diagnoses of mild or severe morning sickness.
Overall, 2.3 percent of women had diagnoses of severe morning sickness, 15.3 percent had diagnoses of mild morning sickness and the rest did not report symptoms of morning sickness.
Among the women with severe morning sickness, 11.3 percent used marijuana, compared with just 4.5 percent of women with no reported symptoms of morning sickness. Marijuana use was also higher among women who had mild morning sickness, with about 8.4 percent of those in this group using marijuana.
It's important to note that the study found only an association between marijuana use and symptoms of nausea and vomiting in pregnancy. Although the results suggest that pregnant women may be using the drug to self-medicate for these symptoms, the study cannot rule out other possible explanations for the findings. For example, doctors could be diagnosing nausea and vomiting in pregnancy more frequently in women who use marijuana, or marijuana may be contributing to symptoms of nausea and vomiting in pregnancy, the researchers said.
Still, the findings suggest that pregnant women with nausea and vomiting should be screened for marijuana use and educated about safe and effective treatments for morning sickness, the researchers said.
"We hope our study can help alert clinicians to the fact that women with nausea and vomiting in pregnancy are more likely to use marijuana," said senior study author Dr. Nancy Goler, an obstetrician/gynecologist at Kaiser Permanente in northern California. "Pregnant women need to be screened and given the information about the possible negative effects while also receiving medically recommended treatment options."
The health effects of using marijuana in pregnancy are unclear, and some studies suggest a link between marijuana use in pregnancy and problems in newborns, such as low birth weight and impaired neurological development. The American College of Obstetricians and Gynecologists recommends that pregnant women not use marijuana.
In future studies, the researchers hope to examine how pregnant women use marijuana — for example, by smoking it or consuming edibles. The scientists also want to study whether trends in marijuana use among pregnant women change when the drug is legalized.
July 21st 2018
Should Breast-Feeding Women Really Drink Guinness?
New mothers are commonly heaped with advice — some of it welcome, some not. But there's one rather unconventional piece of wisdom that stands out from the rest: For decades, women have been told they should drink Guinness — the dark, Irish beer — to boost their production of breast milk and nourish their newborns. To Guinness lovers, this might be a welcome nugget of advice. But does it stand up to scientific scrutiny?
One thing we do know is that the idea has roots deep in history, long before Guinness came along. In fact, humans have been touting the milk-boosting benefits of beer for centuries. As far back as 2000 B.C., records apparently show that the Sumerian people prescribed beer as an aid for breast-feeding. Along with many other foods — like anise, fenugreek (an herb) and oatmeal — beer developed a reputation as a "galactagogue," a food thought to stimulate lactation. Over the centuries, this became an established belief in traditions around the world.
"It's cross-cultural," said Maija Bruun Haastrup, a clinical pharmacologist at Odense University Hospital in Denmark. "Something I find very interesting is that we have this same old-wives tale everywhere."[Does Mom's Drinking Harm Breastfed Babies?]
In the early 1900s, the marketing campaign around Guinness, in particular, gave it a special identity as a "healthful" beverage. Because the beer initially was manufactured with a kind of yeast that gave it a high iron content, it was reportedly offered to blood donors back in the day, or to patients who had just undergone surgery in the hospital. This helped to solidify the drink's original slogan: "Guinness is good for you." Nursing mothers were then encouraged to imbibe this drink as a milk-boosting tonic, too.
While we now know that the campaign around this beverage may have overstated its benefits at the time, Haastrup said there is some scientific truth to the idea that beer boosts breast milk.
"It's important to emphasize that the amount of research here is quite limited," she cautioned. But some studies have drawn a link between a polysaccharide, a type of carbohydrate present in barley hops, and an increase in prolactin, the hormone that aids the production of milk from breast tissue. These factors might explain why beer drinkers of the past sensed that the beverage had a beneficial effect on their capacity to produce milk.
But there's a caveat: Adding alcohol to this hoppy mixture obscures any potential benefit one might get from the barley. Gary Beauchamp and Julie Mennella, two biopsychologists at the Monell Chemical Senses Center in Philadelphia, carried out landmark research in the 1990s showing that when mothers consume alcohol and breast-feed, it seems to alter the flavor of their milk, causing infants to feed less over a certain period of time.
"Essentially, the hypotheses are that the alcohol is affecting either the infant or the mother," Beauchamp, now emeritus director of the Monell Chemical Senses Center, told Live Science.
In a meta-analysis of more than 40 papers, Haastrup identified another pattern in the research, highlighting how alcohol impacts the way the body discharges milk. Breasts release milk through a reflex known as the "letdown," which is triggered by a hormone called oxytocin, Haastrup said.
"Oxytocin is extensively inhibited by alcohol," she said. "So if you ingest alcohol, your oxytocin production is reduced, which leads to a delayed milk letdown reflex." [Why Do Some People Hate the Taste of Beer?]
What can this research collectively tell us about breast-feeding and booze? On one hand, Beauchamp said, "I think it is important for [mothers] to know that the still-prevalent idea that alcohol consumption somehow enhances breast-feeding has no scientific basis."
On the other hand, Haastrup believes that moderate alcohol consumption is less of a hindrance to milk production than it may appear at first. The letdown seems only to be delayed by alcohol, not entirely stopped, she said. Studies have found that babies nursing from mothers who've consumed an alcoholic drink will still feed as much over a 16-hour period as babies whose mothers haven't imbibed at all.
"There isn't a direct inhibition of milk production caused by alcohol, but it makes it a bit more difficult to start breast-feeding," Haastrup told Live Science.
So, what's the verdict for Guinness? It seems that drinking it to enhance breast-milk production probably isn't the best course of action. For that, alcohol-free beers — with all their barley-rich goodness — might be a better bet. "That's why, in maternity wards in Denmark, they actually recommend alcohol-free beer," Haastrup said. "This is something we've known for ages."
But breastfeeding aside, if a nursing mother just feels like having a pint to pass the time while her baby feeds, Haastrup said there's no reason why she shouldn't.
"As far as I can see, there isn't a problem here as long as you follow the general recommendations, only drink occasionally, and drink responsibility," she said. For instance, the American College of Obstetricians and Gynecologists says that a nursing mother would be wise to wait for two hours after an alcoholic drink, before she feeds her infant again. And sure, the alcohol could trigger a temporary delay in milk production — but then, that might just be worth it for the chance to kick back with the occasional beer.
July 14th 2018
Unaware of pregnancy, 21-year-old has twins alone in the bathroom
A woman has told how she only learned she was pregnant when she gave birth to twins in her bathroom after getting up to go to the toilet in the middle of the night.
Beth Bamford, 21, from Stoke-On-Trent, Staffordshire, claims she had no idea she was pregnant because she was still having her periods, and had attributed her weight gain to simply 'fat'.
Beth, who is already mother to three-year-old Elsa-Mae and two-year-old Alivia, gave birth to 5lb 10oz daughter Willow as boyfriend Andy Morris, 22, lay sound asleep just along the landing.
Terrified, she called for an ambulance and emergency services to take her through pushing out the afterbirth, but before they arrived Willow's twin Freya arrived, weighing 5lb 1oz.
Beth was horrified to see Freya, who was breech - meaning she arrived feet rather than head first - wasn't breathing, but medics were able to coach her through a 'little shake' procedure over the phone, and the smaller twin took her first breath.
Beth had visited her doctor numerous times thinking she was ill but neither the mum nor her doctors realised it was because she was pregnant.
Beth had visited her doctor numerous times thinking she was ill but neither the mum nor her doctors realised it was because she was pregnant.
She claims she showed no signs of pregnancy because she was still having her periods, was not eating any more than usual and put the small amount of weight gain down to 'fat'.
However Beth says the new babies are a great surprise addition to her family.
Beth said: 'It's a big shock but a nice surprise. I didn't know I was pregnant at all.
'I was in bed with my partner and I was getting pains. I didn't say anything to him but I went downstairs to get a glass of water and they got worse and I thought I needed the toilet.
'I was still sitting on the toilet when I gave birth. I didn't really have time to feel anything as it was happening.
'It was a rush. One moment I was getting pain and the next moment I have got two new babies.
'I hadn't phoned an ambulance but I called the emergency services and they talked me through it as I gave birth to the first one.
'They told me I needed to get the placenta out. I pushed again but another baby came out, not the placenta. It was a shock.
'The second one wasn't breathing because she was breech. I was panicking about what to do because I wasn't sure what to do with one, let alone two.
'Nobody was answering me when I was shouting and I couldn't wake my partner up because I was on the floor with the babies and couldn't move.
'Andy eventually woke up and walked into the bathroom and just looked at me.
'He went to his mum's bedroom and said: 'Beth's got two babies in the bathroom'.
'She thought he had lost the plot because she knew we had two children already.
‘Two ambulances came and asked lots of questions, like how far along I was or where my notes were.
'They assumed I knew that information and had notes, but I didn't.
'I told them I didn't know I was pregnant or having twins, but nobody believed me – even my partner thought I had hidden it from him.
'I had had the shock of giving birth to babies, and then people accusing me of not knowing.
'I had nothing, no nappies or anything, to take with me to the hospital.'
Doctors believe Beth was around 37 weeks pregnant when she gave birth to the non-identical twins on February 21.
She was told that if she had given birth in hospital, she would have had a C-section because Freya was breech.
The newborns and their mum spent a week in hospital where she and the babies were checked over and monitored for signs of distress.
But Beth, who is already mum to Elsa-Mae, three, and Alivia, two, was happy when all three of them were given the okay to go home.
Beth said: 'I feel lucky because it could have been a lot worse.
'I have settled down a bit now, but it is scary going from two to four. It helped having a lot of support.
'I have not had to go to and buy anything for them, because people went out and bought clothes and baskets and things for them.
'I showed no signs of pregnancy and I even had my periods.
'I have got ulcers in my mouth which stopped me from eating so whatever I was eating went to the babies.
'During my pregnancy I was just doing normal things. I was lifting heavy things, and if they had known at work, I wouldn't have been there.
'I am a fussy eater and I don't go out much anyway but I was still dancing like normal and doing everything that you would do if you're not pregnant.
'Doctors thought I had a viral infection. I don't feel angry. It didn't pop into my head I could be pregnant.
The happy mother-of-four concluded: 'It's a bit of a struggle but I just have to get on with it.'
July 8th 2018
Are Hot Summer Days Risky for Pregnant Women?
Hot, sticky weather can be uncomfortable for anyone. But for pregnant women, the summer heat may be particularly risky.
That's because getting too hot or dehydrated can pose a risk of pregnancy complications, experts say.
Dehydration "can create a lot of potential problems" for pregnant women, said Dr. Saima Aftab, medical director of the Fetal Care Center at Nicklaus Children's Hospital in Miami. As a general rule, doctors caution pregnant women to avoid being in "any situation where they get too hot," Aftab told Live Science. [Are You Pregnant? 10 Early Signs of Pregnancy]
Hyperthermia and early pregnancy
One worry is that hyperthermia, or abnormally high body temperature, in early pregnancy may increase the risk of birth defects. In particular, there's evidence that women who experience hyperthermia in the first six to eight weeks of pregnancy are at higher risk of having babies with defects of the brain or spinal cord (known as neural tube defects), such as spina bifida, Aftab said.
Women may develop hyperthermia from a fever, exposure to excessively hot temperatures outside or even a dip in a hot tub. Indeed, the Mayo Clinic advises women to spend no more than 10 minutes in a hot tub due to the risk of hyperthermia. [5 Weird Ways Hot Tubs Can Make You Sick]
However, Aftab noted that the risk of birth defects tied to hyperthermia is mostly limited to the first eight weeks of pregnancy. In other words, a spike in body temperature that occurs after eight weeks of pregnancy is unlikely to increase the risk of birth defects.
And even if a woman does experience hyperthermia in early pregnancy, the risk of neural tube defects is still low, Aftab said. (There are about 1,500 babies born with spina bifida in the United States each year — a rate of about 3 cases per 10,000 births, according to the Centers for Disease Control and Prevention.)
Women's bodies undergo a lot of changes in pregnancy, including changes in the way their bodies handle fluids and control their temperature. As a result, they may become dehydrated a little more easily, or may be more likely to show symptoms of dehydration, than they would be if they weren't pregnant, Aftab said.
Symptoms of dehydration can include dizziness or lightheadedness, which can be risky for pregnant women if these symptoms cause them to fall, Aftab said. (Falls during the late second and early third trimester can be harmful to both the mother and the baby, leading to complications such as a loss of amniotic fluid, according to the Mayo Clinic.)
In addition, dehydration causes the brain to produce a hormone called vasopressin (also called antidiuretic hormone), which triggers thirst. But this hormone is similar to oxytocin, the hormone involved in stimulating uterine contractions, Aftab said. As a result, dehydration in the third trimester may trigger intermittent uterine contractions, because vasopressin acts similarly to oxytocin, Aftab said.
These contractions, which are not "true" labor, can often be treated with rehydration, according to the University of Texas Southwestern Medical Center. But there's a possibility that the contractions can trigger preterm labor, Aftab said. Dehydration that continues into labor is also risky, because it can lead to complications such as low blood pressure and low blood volume, she said.
For all of these reasons, it's important that pregnant women stay hydrated. "We know that not a lot of good things will happen if a mother is dehydrated" in pregnancy, Aftab said.
Some research has even linked warm weather in certain regions to an increased risk of preterm birth, stillbirth and low-birth-weight babies in a population. For example, in a study published last month in the American Journal of Epidemiology, researchers looked at whether exposure to certain temperatures in pregnancy was tied to the risk of low birth weight (less than 2,500 grams, or 5.5 lbs.), using a population of more than 2 million babies born in California from 1999 to 2013. They found that every 10-degree increase in temperature above 60 degrees Fahrenheit (15.5 degrees Celsius) was linked with a 16-percent increase in the risk of low birth weight.
The study found only an association, not a definite cause-and-effect relationship, and did not take into account whether a mother had ways of reducing her exposure to warm temperatures, such as through air conditioning. As such, more studies are needed to confirm the findings.
However, the study "adds to the growing body of literature that suggests that pregnant women and their fetuses are vulnerable populations following ambient heat exposure," the researchers wrote. "During heat advisory warnings, pregnant women should be included as a vulnerable subgroup for extra precautions," the study concluded.
Aftab said that, on hot days, pregnant women should try not to stay in the sun too long and should avoid exposure to direct sunlight by staying in the shade. To stay hydrated, the Cleveland Clinic recommends that pregnant women drink 10 to 12 glasses of fluids per day.
July 7th 2018
Men can improve their sperm quality by eating nuts daily, scientists say
Men can improve their sperm quality by eating nuts daily, scientists say.
A 60g mix of almonds, hazelnuts and walnuts was found to raise sperm count and the number of healthy sperm, as well as their speed and shape.
Adding a portion of nuts to Western diets could address a global decline in sperm quality in the past 40 years, researchers believe, but it is not known whether men with fertility problems will improve their chances of fathering a child if they eat nuts.
The 14-week study involved 119 healthy and fertile men aged 18-35, who were randomly asked to add a portion of nuts to their normal Western diet or asked to continue eating as normal.
Those in the “nut group” saw their sperm count improve by 16 per cent, sperm vitality by four per cent, sperm motility by six per cent and sperm morphology by one per cent.
They also showed a “significant” fall in sperm DNA fragmentation, which is associated with infertility.
Nuts are rich in antioxidants such as selenium and zinc.
Dr Albert Salas-Huetos, from Rovira i Virgili university in Spain, told a fertility conference in Barcelona: “Evidence is accumulating that healthy lifestyle changes might help conception — and, of course, nuts are a key component of a Mediterranean healthy diet.”
July 5th 2018
Couple who were told they could never have children have miracle quadruplets after years of trying
· Selina Torbett and Kev Ashe had their first daughter Myla through IVF treatment
· They had just two frozen eggs left but were desperate to give little Myla a sibling
· Selina was warned that she could not conceive naturally due to health problems
· But she went on to have four quintuplets Roman, Arlo, Austin and Raeya
· A couple who were told they could never have children now have five - after they had miracle quadruplets.
· Selina Torbett, 28, and Kev Ashe, 35, had their first daughter Myla through IVF treatment after years of failed fertility treatments, but with just two frozen eggs left, the couple were desperate to give her a sibling.
· Now three years old, Myla has her work cut out playing with identical triplet brothers and her little sister - the result of the two 'last chance' eggs, one of which split three ways.
· Selina, who works as a hospital ward sister, had never had periods, and suffered from polycystic ovaries and endometriosis, so always feared she would have problems with her fertility.
· Doctors warned her she was likely to experience early menopause and would never conceive naturally.
· The couple were even told by medics that they should abort the quadruplets because of high miscarriage risk, early labour and other complications, but Selina and Kev were desperate to give their babies a fighting chance.
· Selina, from Winchester, Hants, said: 'It is unbelievable. We had one little miracle - then we had four more.
· 'It is exhausting and totally insane but we wouldn't change it for the world.
· 'We look at our family and feel filled with so much love.'
· Selina and Kev, a decorator, met in a local pub when Selina was just 19, and two years later they started trying for a baby after Selina's gynecologist told her she needed to get started as soon as possible.
· After three years of negative pregnancy tests and procedures such as ovarian drilling, where holes are made in the ovaries to help them release eggs, Selina was finally allowed to get IVF treatment on the NHS.
· Selina explained: 'We were trying all of those methods but nothing was working.
· 'It was a very hard time. We both wanted a family so much.
· 'I remember everyone around us was having children and we felt desperate to have that.
· 'When all of these things weren't working, I feared we'd never be parents and we did talk about adoption and fostering.
· 'We wanted to try IVF but at that time you had to be at least 31 to have it on the NHS.
· 'I remember that just as I was coming up 24, that changed, and our GP called to say they dropped the age to 24.
· 'The IVF took three months. We didn't really have much hope that it was going to work, because everything else had failed.
· 'When we had IVF, we went in thinking it wasn't going to work - but it worked first time.
· 'In October 2014, Myla was born. When she was a year old, we thought we wanted to try again.'
· The couple had just three frozen eggs remaining, and went through two more years of trying for another baby, spending their savings for a mortgage on the costly treatment.
When all of these things weren't working, I feared we'd never be parents and we did talk about adoption and fostering.
'We wanted to try IVF but at that time you had to be at least 31 to have it on the NHS.
'I remember that just as I was coming up 24, that changed, and our GP called to say they dropped the age to 24.
'The IVF took three months. We didn't really have much hope that it was going to work, because everything else had failed.
'When we had IVF, we went in thinking it wasn't going to work - but it worked first time.
'In October 2014, Myla was born. When she was a year old, we thought we wanted to try again.'
The couple had just three frozen eggs remaining, and went through two more years of trying for another baby, spending their savings for a mortgage on the costly treatment.
Selina added: 'The second attempt at IVF failed. We were shocked because we had such high expectations after our first try with Myla - I was very upset by it.
We were so desperate to complete our family. It was a dark and horrible time.
'IVF is hard on your body and I wanted to give it our best shot. I felt we were missing out on life because we were concentrating so much on the IVF that life just stood still.'
Each IVF attempt cost around £3,000, so the couple had to save up each time they wanted to try again.
'With the last two eggs, we decided this was our final chance, we wouldn't try to do any more.'
The couple were thrilled when what would be Selina's final pregnancy test came back positive, but she was experiencing heavy bleeding and was terrified of losing the baby, so asked a colleague at the hospital where she worked to scan her at five weeks.
She said: 'I hadn't told Kev because I didn't want to worry him.
'They told me there were four pregnancy sacs so potentially four babies and I was in utter disbelief.
I phoned Kev to tell him and he thought I was joking. My colleague had to print out all the paperwork! I had been continuing to bleed heavily though so I didn't fully process the news.'
Two weeks later, Selina and Kev returned to the fertility clinic for the official scan and were stunned and overjoyed when the sonographer discovered four healthy heartbeats.
She added: 'But we had quite a lot of negativity from the healthcare professionals and they wanted us to abort the identical triplets - which we didn't know at that time were three boys.
'They thought they probably wouldn't all survive, but we thought we would let fate take it's course.
'It was very difficult and we knew the risks were high but we decided to go ahead and accept that.
'We'd already been through so much to complete our family. We hoped we could be the ones to defy the odds and so we plodded on.
'The pregnancy was tough but there were no ma jor complications and I tried to do everything possible to keep them as safe as I could.
'It was disabling but I felt more and more reassured as I grew bigger.
'I needed help getting out of the bath, I passed out at every two week scan as we had due to the weight of all the babies pressing against my spine.
'At one point I even measured 4ft 8in wide for my 5ft 2in frame but I kept defying the odds and doctors were amazed.'
The quadruplets arrived 11 weeks early at 29 weeks gestation, being born on July 23 last year.
Now the three boys - Roman, Austin and Arlo - who Selina describes as 'chilled out', and their tiny sister 'cheeky' Raeya, who still wears clothes designed for a three-month-old, are set to turn one.
'We got the boys bracelets with their initials on them so that we can tell them apart,' Selina joked.
The parents, who are hoping to move to a larger house before the big day, are planning to hold a family barbecue to celebrate their miracle quadruplets.
Selina added: 'One of the doctors joked with Kev that the odds were so slim, it is more
likely he'd win the jackpot than have quads.
'To think we thought we could never have children and now we are outnumbered by five is crazy, but I feel like we have won the lottery and it's better than anything money could buy.
'To have them all at home together for the first time was very overwhelming.
'Every time I look at them all, I feel incredibly proud. We did it, despite all the people who doubted us.
'I have always longed for a big family but had accepted that wouldn't happen for me - but our babies are proof that miracles do happen, and I feel so blessed.'
June 12th 2018
New Barrel-Shaped Structure Discovered Inside Sperm
Human sperm cells are well-studied, so scientists were completely surprised to find a previously unknown structure in the little swimmers. And perhaps more surprising, this newfound structure may contribute to infertility, miscarriages and birth defects, the investigators said.
On the flip side, once scientists understand this structure better, it may help them develop new therapies for male infertility and learn more about early human embryonic development, the researchers said.
The newly identified part is a centriole, a barrel-shaped structure made of short microtubules. Researchers already knew that sperm cells contain one centriole, but the new discovery brings the total to two centrioles per sperm. [Sexy Swimmers: 7 Facts About Sperm]
However, the newfound centriole has a slightly different structure than the previously known one, so the researchers are calling it atypical in shape.
"This research is significant because abnormalities in the formation and function of the atypical centriole may be the root of infertility of unknown cause in couples who have no treatment options available to them," study researcher Tomer Avidor-Reiss, a professor in the Department of Biological Sciences at the University of Toledo in Ohio, said in a statement. "It also may have a role in early pregnancy loss and embryo development defects."
Previously, researchers thought that sperm carried just one centriole, which then duplicated itself if the sperm met an egg. That's because the egg does not have a centriole, while a zygote — or a fertilized egg — needs two centrioles to start the development of a fetus, the researchers said.
These centrioles play a pivotal role. They are needed for building the cell's cytoskeleton (the structure that maintains cell shape) and completing accurate cell division, the researchers noted.
By learning how centrioles work during the early stages of reproduction, scientists may be able to pinpoint if these structures are involved with any type of male infertility or later problems with the developing embryo.
"Since the mother's egg does not provide centrioles and the father's sperm possesses only one recognizable centriole, we wanted to know where the second centriole in zygotes comes from," Avidor-Reiss said. "We found the previously elusive centriole using cutting-edge techniques and microscopes. It was overlooked in the past, because it's completely different from the known centriole in terms of structure and protein composition."
This isn't the only recently uncovered structure in human sperm. Earlier this year, researchers announced the discovery of a mysterious spiral in the tail of human sperm; this structure may give the sperm a boost while it's swimming, Live Science previously reported.
The new study was published online June 7 in the journal Nature Communications.
June 9th 2018
Just two months of stress can affect sperm quality, study reveals
Going through a stressful period may affect your fertility, according to a worrying new study.
Researchers from Ben-Gurion University have found that prolonged stress, such as that experienced during military conflict, can impact sperm quality.
Dr Eliahu Levitas, who led the study, said: “Mental stress is known to have an adverse effect on fertility, but there is little research on the impact of stress on sperm quality.
“This study shows that prolonged stress can have an effect on sperm quality."
In the study, the researchers analysed 10,536 sperm sample donated during unstressful periods between 2009-2017, and compared them to 659 sperm samples taken up to two months after military conflicts between Israel and Gaza in 2012 and 2014.
The analysis revealed that 37 per cent of the sperm samples taken during the stressful period had low sperm mobility.
And overall, sperm samples from the stressful period were 47 per cent more likely to have weak motility than those taken during unstressful periods.
Weak motility makes it less likely that the sperm will successfully fertilise an egg.
Dr Levitas added: “Our reasoning was that even men who heard incoming rocket warning sirens during a conflict experienced stress throughout the day over a longer period.
“We were surprised to discover that there is a connection between the security situation and the sperm counts."
June 6th 2018
Britain's first baby born by womb transplant expected by 2020
Britain's first baby born as a result of a womb transplant could happen as early as 2020.
Richard Smith, the surgeon planning to carry out the first transplant in the UK, has set the two-year target and revealed that his medical team now plans to use living donors.
He hopes the first transplants will take place before the end of this year thanks to a pioneering medical technique, but £30,000 is needed for every patient.
Three women hoping to realise their dreams of motherhood will undergo surgery within the next few months using wombs donated by a mother or sister, it was reported.
Doctors in the UK were granted approval to carry out Britain's first 10 womb transplants in 2015 using wombs from deceased donors whose hearts are still functioning. But Mr Smith, a consultant gynaecologist who leads researchers at the charity Womb Transplant UK, said his team will now use both live and deceased donors.
Mr Smith, of Queen Charlotte's and Chelsea Hospital in London, told the BBC that retrieving a womb from a live donor is now simpler and safer than it was just a few years ago. The surgery time has been drastically reduced from 12 to four hours.
Mr Smith said the risks of clot formation, deep vein thrombosis and damage to pelvic organs have been greatly reduced.
About 750 women have contacted his team to enquire about womb transplantation. Mr Smith's team has been in contact with about 50 potential recipients after a preliminary selection process, and the patients will be chosen within weeks. They include women with relatives willing to donate their wombs.
Womb Transplant UK is hoping to complete 15 transplants - five with living, related donors - but so far only has enough funds to pay for three operations. The treatment costs £30,000 per patient, meaning the charity needs to raise hundreds of thousands of pounds to cover the remaining treatments and surgeries.
The procedures will be performed at NHS transplant centres, but the costs will be covered by the charity and members of the medical team are donating their services.
It is estimated that there are 6,000 women in the UK who were born without a womb. Others have lost theirs to cancer.
Mr Smith said the prospect of a British woman being helped to conceive with a transplanted womb is "truly exciting". He told the Daily Mail: "We have the opportunity to make a real difference.
"It's a major step forward for women with absolute uterine infertility. Until now their only options have been adoption or surrogacy, which is not always easy."
The first successful birth after a womb transplant was achieved in Sweden in 2014.
The technique has also been carried out in countries including the US, Germany, China and Turkey.
May 15th 2018
The most common cause of female infertility – polycystic ovary syndrome – may be caused by a hormonal imbalance before birth. The finding has led to a cure in mice, and a drug trial is set to begin in women later this year.
three-quarters of whom struggle to fall pregnant. The condition is typically characterised by high levels of testosterone, ovarian cysts, irregular menstrual cycles, and problems regulating sugar, but the causes have long been a mystery. “It’s by far the most common hormonal condition affecting women of reproductive age but it hasn’t received a lot of attention,” says Robert Norman at the University of Adelaide in Australia.
Treatments are available for helping affected women get pregnant, but their success rates are typically less than 30 per cent across five menstrual cycles.
Now, anti-Müllerian hormone.
The researchers discovered that pregnant women with polycystic ovary syndrome have 30 per cent higher levels of anti-Müllerian hormone than normal. Since the syndrome is known to run in families, they wondered if this hormonal imbalance in pregnancy might induce the same condition in their daughters.
To test this idea, they injected excess anti-Müllerian hormone into pregnant mice. As their female offspring grew up, they displayed many of the hallmarks of polycystic ovary syndrome, including later puberty, infrequent ovulation, delays in falling pregnant, and fewer offspring.
The excess hormone seemed to trigger this effect by overstimulating a set of brain cells that raise the level of testosterone.
Cure in mice
The team were able to reverse this effect in the mice using cetrorelix, an IVF drug routinely used to control women’s hormones. After treatment with this drug, the mice stopped showing symptoms of polycystic ovary syndrome.
The team is now planning a clinical trial of cetrorelix in women with the condition, which they hope to start before the end of the year. “It could be an attractive strategy to restore ovulation and eventually increase the pregnancy rate in these women,” says Giacobini.
“It’s a radical new way of thinking about polycystic ovary syndrome and opens up a whole range of opportunities for further investigation,” says Norman.
If the syndrome is indeed passed from mothers to daughters via hormones in the womb, that could explain why it’s been so hard to pinpoint any genetic cause of the disorder, says Norman. “It’s something we’ve been stuck on for a long time,” he says.
The findings may also explain why women with the syndrome seem to get pregnant more easily in their usually signalling reduced fertility. But in women who start out with high levels, age-related declines may bring them into the normal fertility range – although this still needs to be tested, says Norman.
May 5th 2018
Can a high fruit diet help women conceive?
Eating plenty of fruit could help women conceive, a new study suggests.
Researchers who looked at more than 5,500 women from Britain, Ireland, Australia and New Zealand found those who consumed the least fruit were 50 per cent more likely to be infertile.
And compared to women who ate fruit three or more times a day in the month before conception, women who ate fruit less than one to three times a month took half a month longer to become pregnant.
Similarly, compared to women who never or rarely ate fast food, women who consumed fast food four or more times a week took nearly a month longer to become pregnant. Their risk of infertility also doubled from eight to 16 per cent.
However the amount of green leafy vegetables and fish made no difference to conception times.
Professor Claire Roberts, of the University of Adelaide, Australia, who led the study, said: "These findings show that eating a good quality diet that includes fruit and minimising fast food consumption improves fertility and reduces the time it takes to get pregnant."
First author, Dr Jessica Grieger, post-doctoral research fellow at the University of Adelaide, added: "We recommend that women who want to become pregnant should align their dietary intakes towards national dietary recommendations for pregnancy.
“Our data show that frequent consumption of fast foods delays time to pregnancy."
Previous research has focussed on the role that diet plays in women diagnosed with or receiving treatment for infertility however the impact of diet before conception for the general population has not been widely studied.
For the study pregnant women were surveyed by midwives on how long it had taken them to become pregnant, as well as their intake of fruit, and fast foods such as burgers, pizza, fried chicken and chips.
Dr Grieger said: "Most of the women did not have a history of infertility.
“We adjusted the relationships with pre-pregnancy diet to take account of several factors known to increase the risk of infertility, including elevated body mass index [BMI] and maternal age, smoking and alcohol intake.
“As diet is a modifiable factor, our findings underscore the importance of considering preconception diet to support timely conception for women planning pregnancy."
The research was published in the journal Human Reproduction .
April 25th 2018
Biology tends to play tricks on women
Before the digital age, the workings of the female body were even more mysterious and challenging to follow than today. Although women always had to be aware of the milestone dates of their cycles every month, tracking it was a hassle. Ten or fifteen years ago, paper-based menstruation calendars were supposed to help, but they usually had a tiny, not very user-friendly format, could not set reminders or send notifications, so it was easy to forget about them altogether.
Not to mention that women’s bodies are nothing like a Swiss atomic clock, sensitivity towards the weather or other environmental factors, stress or health issues can easily influence cycles. So, for many women the first day of menstruation usually came out of the blue, causing stress and unpleasant moments. Talking to the gynecologist could be an embarrassment, too, if you tended to forget the exact dates since the first thing they usually ask is about the cycle.
The entire situation was somewhat similar to ancient methods of fertility tracking, which were as efficient as trying to guess the number of red candies in a pack of M&Ms. When a couple wanted to start a family relatively fast, and they did not mind helping the process with a little bit of planning, they had to rely on rough estimations of menstruation and ovulation cycle. Luck, coincidence, God or the “universe” played a huge role in family planning.
e Ava fertility tracker offers a viable alternative to
menstruation and fertility tracking apps as it promises accurate data
measurement and a user-friendly solution for women trying to get pregnant. We
tested the tracker and had an overall positive experience. Here’s our verdict.
Biology tends to play tricks on women
Technology helps reduce the role of luck
When smartphones with cycle and ovulation tracking apps appeared, many women could feel a bit relieved. Via the majority of these apps, you can not only track your period – together with any symptoms, such as mood swings, severe cramps, headaches, bloating -, but they usually predict when your next cycle begins. In the last couple of years, some apps have even been amended with machine learning technologies to read data patterns and predict the workings of the female body even more precisely. Period Calendar, Flo Period Tracker, Clue, My Calendar, Glow, Eve, Period Tracker Lite, Period Plus, My Cycles, Cycles – the list is too long to recount; these were the best ones according to Medical News Today in 2018.
The situation is somewhat similar when looking at the landscape of fertility trackers as they are understandably linked to menstruation cycle tracking. Glow, Clue and many other period trackers help figure out when is the best time to conceive, too. Many apps, such as Fertility Friend or Ovia use only data to try to do the guesswork, but many others already realized that they need sensors for estimating ovulation more accurately. Kindara and Natural Cycles use specific thermometers, Daysy has a fertility monitor, OvaCue and Me.Mum use saliva. Maja Bujas, CEO, and Co-founder of Me.Mum told The Medical Futurist that she developed her saliva testing solution for women using smartphones when she wanted to get pregnant. She aimed to increase accuracy and offer a user-friendly procedure that anyone can do at home.
The Ava fertility tracker has a similar promise, but a different solution. They use a wristband to measure many health parameters, just as in case of a fitness tracker, while you follow your results and estimations on a smartphone app. It certainly looks promising, and the editor of The Medical Futurist had the chance to test and review it for you. Let’s see how it performed!
Ava: cycle, fertility and pregnancy tracker
The Zurich-based company developed Ava for women who want to know more about their bodies: observe their menstruation or ovulation cycles or follow their pregnancies. Via logging symptoms as well as data, users can identify changes that may indicate potential health issues, while they can also get a clearer picture and a more accurate prediction when they are likely to be most fertile – not matter whether they try to get pregnant or avoid that situation.
The tracker itself is a fitness wristband-like device. It has a neat and streamlined design with a lovely color. It is great to see that designers and developers are moving beyond the girly equals pink and boyish equals blue scenario. Moreover, the sensor itself is put into a grey shell inspired by the process of conception – the logo of Ava also resembles that. In the box, you can find the bracelet itself, the micro USB cable for charging, as well as some information about the product.
The charging and the measurement process
Before going into details about what and how Ava measures, some words about the measurement process and charging the device. The latter is apparently the weakest point of the tracker. You have to charge it every day by plugging it into your computer or any other machine with a USB connector. When you plug it in, the tracker first starts synching with the Ava app via Bluetooth to read the measurement data. It works nicely, although sometimes you cannot really see whether the bracelet is charged as if you don’t connect it to the app, a blue dot is flashing for a while. But then it becomes quite clear: if the dot lights up red, it needs charging, if it’s green, the Ava is ready for use.
It is convenient that you do not have to wear the Ava bracelet throughout the entire day, only at nights. You just put on the bracelet and go to sleep. The users only have to keep in mind that the tracker only works if they wear it for at least four hours with three hours of sleep. But let’s be honest here: that doesn’t sound like an unachievable goal. It is an excellent feature of the sensor that it lights up green when it touches the skin, so the user precisely knows it started to work.
Source: Ava Women
What does Ava measure and how?
The company says on its website that Ava was clinically tested in a year-long study at the University Hospital of Zurich, and their first findings were published in the peer-reviewed journal Scientific Reports. It is an FDA-registered and a CE-certified device which measures skin temperature, resting pulse rate, breathing rate, heart rate variability ratio, perfusion, movement, bioimpedance, heat loss and sleep.
Ava measures skin temperature to identify fertility phases – as skin temperature rises by about 1.5 degrees after ovulation and it remains elevated until the next period. During pregnancy, skin temperature is also higher than usual. It is also useful to know that skin temperature is generally lower than the value you get with a thermometer. The tracker measures resting pulse rate, which is higher at the beginning of the fertile phase. The value varies between 40 and 80 bpm, but if someone is more physically active, the rate might even go lower than 40.
The range for breathing rate is between 10-25 bpm, and it’s usually higher in the phase before menstruation. The heart rate variability ratio or HRV ratio is the variation in the time interval from one heartbeat to the next. Researchers use it as an indicator of physiological stress. In the case of Ava, the lower the HRV ratio, the less stressed you are.
Ava measures your sleep as well: how much light, deep sleep you experience and how much time you spend at night in REM phase. Although there are many other trackers for sleep quality, this information is useful to see how menstruation affects sleeping patterns.
Personal experience with Ava
While it took a learning period – approximately one week – to get Ava into the daily routine before going to bed, the richness of data compensated for the tiny inconveniences. The tracker and the app work nicely. The app displays data in a very user-friendly way and shows little tips for women – when to try getting pregnant, what happens during the luteal phase, what happens with an unfertilized egg. It’s easy to use and very straightforward.
Although we do not have a way to show whether the data is indeed accurate, and we cannot expect the same accuracy as in the case of the major fitness trackers, it seems to work and be in line with expectations. You can even receive your data in an e-mail and show it to your gynecologist.
The Ava fertility tracker clearly represents a niche area as many women believe apps are not enough for fertility tracking anymore but want something more accurate and user-friendly, which they can use at home. The fact that it can also track stress levels or sleep is a bonus. Although we would not recommend it for daily use mainly because of the charging issue, if a woman wants to get pregnant, it is genuinely worth discovering what Ava has to offer. And along the way, you might find something about your body that you never knew.
April 24th 2018
First scrotum and penis transplant performed in John Hopkins University
A man who lost his genitals in a war injury has received the world's first full penis and scrotum transplant.
Surgeons at Baltimore's John Hopkins University have rebuilt the veteran's entire pelvic region from the parts of a deceased donor.
It is hoped that the operation will give the injured man full urinary and sexual function within weeks.
In an ambitious March operation lasting 14 hours, surgeons connected tiny nerves, blood vessels, skin, muscles and tendons to rebuild both the man's penis and extensive surrounding tissue.
While a handful of successful penis transplants have been reported in recent years, this was the first to reconstruct the scrotum as well - making it far more complex and expensive than previous procedures.
The recipient, who wishes to remain anonymous, said he "felt finally more normal" on waking up from the operation.
"It's a real mind-boggling injury to suffer; it is not an easy one to accept," he said.
The extent of the patient's injuries - he had lost his penis, scrotum, and much of his abdominal wall - meant taking an exact replica of what was missing was the most sensible option for the surgeons treating him.
"We've really replaced like with like," surgeon Dr Richard Redett said. "We looked at the defect our patient had and procured the exact same graft from our donor."
The full transplant is radically different to current procedures - often used in transgender surgery or to treat congenital abnormalities - that use a patient's own skin to construct a penis.
Such operations require patients to use an implant to achieve an erection, bringing a higher risk of infection than the highly experimental full transplant.
But while they avoid such problems, transplants present new ethical problems in penis surgery.
The families of deceased donors need to give explicit permission for a penis - as parts of the face or hands - to be given for transplant, for example.
It was also decided in this operation that a scrotum transplant should not extend to the donor's testicles, which would bring the possibility of having children. "We just felt there were too many unanswered ethical questions," surgeon Damon Cooney said.
Surgeons at John Hopkins described lost penises as "an unspoken injury of war", suffered in silence by patients who face stigma as well as a loss of sexual intimacy and urinary function.
The US Department of Defense trauma registry has recorded 1,367 male service personnel with having suffered genitourinary injuries between 2001 and 2013, although it is not clear whether how many of those resulted in the loss of all or part of the penis.
Patients can also lose a penis through cancer or accidents. One previous penis transplant, in China, was reversed after psychological problems experienced by the recipient and his wife.
After the surgery in March, however, doctors say the first penis and scrotum recipient is doing well.
March 15th 2018
Male infertility is the most common reason couples in the UK have IVF treatment, official UK data has revealed.
The most common reasons for IVF treatment after male infertility (37%) were ovulatory disorder (13%), blocked fallopian tubes (12%) and endometriosis (6%), although in 32% of cases the cause of infertility was unexplained.
The Human Fertilisation and Embryology Authority’s (HFEA) report for 2014-2016 revealed that 40 years after the first child was born following in vitro fertilisation, IVF treatment is at the strongest it has ever been in the UK. The report showed that in 2016, more than 68,000 IVF treatments were performed (an increase of 4% from 2015), with over 20,000 babies born. Current treatments are now 85% more likely to succeed than when records began in 1991, as the average birth rate per embryo transferred for women of all ages is 21%.
“Assisted reproduction has come a long way in the 40 years since British doctors pioneered IVF with the birth of Louise Brown,” said Sally Cheshire, chair of the HFEA. “With well over a million treatments performed in the UK since records began, and more than 300,000 babies born, as a country we remain at the forefront of fertility treatment.”
Age remains the single most important factor for successful outcomes from fertility treatment. The average birth rate for women of all ages is 21%, while women under 35 have a 29% chance of a successful birth.
In 2016, 42% of patients undergoing IVF treatment cycles were aged under 35. 23% were aged between 35-37, 14% aged 38-39, 14% 40-42, 4% 43-44 and 3% over 44 (1,812).
The HFEA noted several other trends in its latest report: Treatments involving donor eggs and sperm are becoming more popular. In 2016, 4,306 treatment cycles involved a patient using their own eggs and donor sperm, up 15% from 3,749 in 2015. There were also 3,000 IVF treatment cycles using donor eggs and partner sperm – a year-on-year rise of 6%.
The report also found that since 2014, the number of IVF treatments for patients with a female partner has increased by 30% and the number of IVF treatments for patients with no partner increased by 35%. IVF treatments for patients with a male partner increased by 6% over the same period.
Overall, heterosexual couples still account for the vast majority of all treatments. In 2016, 64,903 IVF treatments were for women who registered with a male partner (95%); 1,683 for women who registered with a female partner (3%) and 1,272 for women who registered with no partner (2%).
I am delighted to see that more people than ever before are able to have successful treatment."Sally Cheshire CBE, chair of the HFEA
Despite a general increase in birth numbers, the report revealed that the multiple birth rate continues to fall. This is a positive step, as multiple births carry significant risks for both mother and child. Multiple births have reduced from 28% of IVF births in 2008 to 11% in 2016 - its lowest rate to date.
Other significant findings included the number of cycles using eggs frozen for later treatment rose by 10% in the last recorded year, with 1,170 freezing cycles in 2016. The age profile for women having egg thaw cycles is very different from standard IVF treatment, with the largest group aged over 44 (27%). Only 17% of patients using thawed eggs in treatment were aged under 35.
And, for the first time ever, the HFEA detailed the number of surrogacytreatments taking place in UK clinics: 232 surrogate cycles, and 79 births in 2016. The birth rate for surrogates is also higher than IVF overall, at 26% when using fresh embryos.
Cheshire added: “I am delighted to see that more people than ever before are able to have successful treatment. But the same level of care must be shown to those patients whose treatments do not result in a birth. In that way, the UK will lead not just in clinical treatment, but in the provision of vital emotional support from the beginning to the end of each patient’s journey”.
In 2016, 41% of IVF treatments across the UK were funded by the NHS, a ratio that has remained broadly stable since around 2010.
March 10th 2018
Fish oil and probiotic supplements for pregnant mothers may decrease children's allergy risk
Fish oil supplements and probiotic yoghurts during pregnancy may decrease children’s risk of developing allergies, a major evidence review has found.
The study on how childhood allergies are influenced by mothers’ diet also found that avoiding key foods like peanuts, eggs and dairy had little impact on future allergies or eczema.
The findings are now being considered by the British Government and could influence new dietary guidance for expectant mothers and infants.
“Food allergies and eczema in children are a growing problem across the world,” said lead author Dr Robert Boyle from the Department of Medicine at Imperial College London.
“Although there has been a suggestion that what a woman eats during pregnancy may affect her baby’s risk of developing allergies or eczema, until now there has never been such a comprehensive analysis of the data.
“Our research suggests probiotic and fish oil supplements may reduce a child’s risk of developing an allergic condition, and these findings need to be considered when guidelines for pregnant women are updated.”
Food allergies affect around one in 20 children in the UK.
These are caused by the immune system becoming sensitive to harmless chemicals in foods like peanuts or dairy and over-reacting. Then this triggers the body’s defence response that includes rashes swelling, and the closing off of the airways.
Eczema, a condition causing cracked, dry and itchy skin, affects 20 per cent of UK children. It is also linked to children having a higher risk of food allergies, although it’s not clear why.
The Imperial team reviewed over 400 studies, covering 1.5 million people, on the link between maternal diet, allergies and breast feeding, for the research – which is published in PLOS Medicine. It was funded by the Food Standards Agency.
Pooling multiple studies in this way means results are less likely to be statistical one offs.
The studies on probiotics and fish oil were all controlled trials where mothers were randomly assigned to a particular diet instead of just reporting what they ate, which also lends credibility to the results.
Looking at 19 studies where mothers took a daily fish oil capsule, they found there was evidence to suggest the daily omega-3 supplement from 20 weeks of pregnancy, and in the first three to four months of breast feeding, decreased the risk of allergies.
These studies tested infants for an egg sensitivity as a proxy for developing other allergies in future.
There was also some evidence to suggest omega-3 could reduce peanut allergies, by as much as 38 per cent. However this was only identified in two studies and therefore not as reliable.
The 30 per cent reduction amounts to around 31 fewer children with an egg allergy for every 1,000 mothers following this regime.
It also looked at 28 trials, covering 6,000 women, taking a variety of probiotic supplements 0 though most of them contained a bacterium called Lactobacillus rhamnosus.
While probiotic yogurt drinks are one source of these sort of gut boosting bacteria, most don’t contain a high enough concentration of helpful bacteria and these studies mostly looked at pill or powder supplements.
The analysis found taking probiotics in the last few weeks of pregnancy and in the first three to six months of breastfeeding, was related with a 22 per cent decrease in eczema cases in children – around 44 fewer cases in every 1,000.
Researchers found some limited evidence to support the suggestion that maternal breast feeding alone helped reduce eczema rates, and could also have benefits for lowering the risk of type one diabetes.
But there was not enough evidence to support other supplements, or leaving out certain foods.
“This is an important, well conducted piece of research, which adds to the growing evidence suggesting that nutrient supplementation during pregnancy and lactation may have the potential to prevent childhood allergy and allergic disease,” said Seif Shaheen, professor of respiratory epidemiology at Queen Mary University of London, who was not involved with the study.
Mar 1st 2018
Things you need to know about endometriosis and fertility
Endometriosis is a common and long-term condition which affects roughly one in 10 women in the UK.
It occurs when the lining of the uterus (endometrium) grows in other places, such as the fallopian tubes, ovaries or along the pelvis. The condition causes heavy and painful periods as well as pain in the lower abdomen, pelvis, or lower back.
Approximately 30% of women with endometriosis have fertility problems, which can occur as a result of scarring on the tubes and ovaries, issues with the quality of the egg or problems caused by the embryo travelling down the tube and implanting in the wall of the uterus.
For those of you who are worried about your fertility following an endometriosis diagnosis, we caught up with Mr Anthony Rutherford, Consultant Gynaecologist in reproductive medicine and surgery at Leeds Centre for Reproductive Medicine, who gave us his advice on how to deal and treat endometriosis in order to preserve fertility...
1.Act on your symptoms
"It is very important that women are aware of the symptoms of endometriosis as you may not discover you have the disease until you are actively trying for a baby. If you have a history of painful periods, including pain before you start your period as well as during, and have experienced pain during sex then I would advise speaking to your doctor.
"Early referrals for women with endometriosis are vital as surgical treatment in most circumstances would improve your outcome of natural conception in the future. In the biggest surgical study conducted in women with endometriosis, patients who had treatment for the disease compared to those that didn't were assessed across a nine-month period post treatment. The results showed a 17% chance of natural conception if women had no treatment and a 30% chance if they had treatment."
With diagnosis for endometriosis taking an average of 7.5 years in the UK, Endometriosis Awareness Week (3rd - 11th March) is aiming to raise awareness of the signs and symptoms of the condition for women who may not yet have a diagnosis.
2.Endometriosis doesn't stop conception
"Women with endometriosis can get pregnant naturally but have about half the chance of getting pregnant compared to their peers of a similar age. If you have been diagnosed I would recommend asking your doctor about your options as each case needs to be treated individually. This could involve trying to conceive naturally for six months or surgery to aid conception. If you have been trying for 2-3 years then you should explore alternative methods such as IVF as this would improve the chances of conceiving."
3.Don't rush into invasive surgery
"Having invasive surgery when you are already trying to conceive could delay conception, as medical management of the condition involves suppressing ovulation (which of course will stop you getting pregnant). There is no evidence that treating endometriosis before IVF would improve the outcome.
"I think that a lot of patients might benefit from not having to go through difficult and stressful surgery at a time when they are trying to conceive. Ultimately, having surgical treatment when you are already struggling with conception delays the fertility treatment itself and further delays the pregnancy. The other consideration about operating on an endometrioma is that while an ovarian cyst may be removed part of the normal functioning ovarian tissue may also be removed and that would mean a woman's ovarian reserve would be reduced on that side."
Mr Anthony Rutherford will be attending The Fertility Show, which takes place in Manchester from the 24th-25th March.
Feb 14th 2018
Five myths about emergency contraception you need to stop believing
Being clued up on emergency contraception (EC) is a must for anybody wanting to enjoy worry-free sex. However, it can often be difficult to separate certain facts from unhelpful fiction. Here, we bust some common EC myths for good.
1. There is only one method of EC available
WRONG. There are actually two forms of emergency contraception that can be used to prevent pregnancy after unprotected sex. These are the emergency IUD (AKA the emergency coil) and the morning after pill. Pharmacist Deborah Evans explains:
"You should speak to a healthcare professional about the various options available and the differences in effectiveness to ensure you are able to make an informed decision based on what is most suitable for you. We are there to help you at what can be a very anxious time."
2. EC can only be use the morning after unprotected sex
The term 'morning after pill' is actually very deceiving, as you're supposed to use emergency contraception as soon as possible after having unprotected sex.
However, the timescale does vary depending on what sort of EC you take. Levonorgestrel pills can be taken within three days (72 hours) of unprotected sex, while ulipristal acetate pills (such as ellaOne) can be used within five days (120 hours). The emergency IUD can also be inserted up to five days after unprotected sex. Deborah says:
"Both pills work by preventing or delaying ovulation and must therefore be taken as soon as possible as they are not effective if ovulation has already taken place, so the sooner the better. The emergency IUD… Isn't always the most practical [choice], as it must be fitted by a trained health care professional."
3. The morning after pill affects your fertility</h3>
There is no evidence that taking the morning after pill, even multiple times, will affect your fertility or reduce your chances of falling pregnant in the future. It also does not work by causing an abortion or an 'emergency period'. Deborah explains:
"The morning after pill works by delaying or inhibiting egg release. This means that the sperm waiting in the fallopian tubes will be unable to meet an egg and fertilise it. This is similar to regular contraceptive pills, which also work by preventing egg release."
"EC will not protect you from possible pregnancy if you have unprotected sex again several days after taking it. If you want to have sex after using the morning after pill, use a barrier method (like a condom) until your next period even if you use regular contraception. If you do not have a regular contraception method in place, then have a conversation about the options available with your healthcare professional."
4. EC comes with lots of side effects
All medicine comes with potential side effects, but that doesn't mean everyone will experience them in exactly the same way.
"The most common side effects are headaches, nausea, tummy pain and painful periods. Women sometimes experience delayed periods and if this happens, you should take a pregnancy test or speak to a healthcare professional. If you become ill (and vomit) within the first three hours after taking the morning after pill, you will need to go back to the pharmacy and take another one immediately."
5. The morning after pill is difficult to get</h3>
There are all sorts of channels through which you can access emergency contraception, including direct from the pharmacy (without a prescription), a sexual health clinic, your GP or a walk-in centre. It is also possible to order the morning after pill online, although research suggests that only 7% of women are aware of this. All you have to do is complete a selection of health-related questions on the pharmacy website to ensure the medication is appropriate for you. Deborah comments:
"[Ordering] the emergency contraceptive pill in advance allows you to have a provision to hand in your medicine cabinet. This means you can take it as soon as possible should you ever need to in the future, however if anything has changed in your general health or you are taking any new medicines, then do ask for some advice from your pharmacist before taking it."
If you require emergency contraception after unprotected sex or contraceptive failure, bear in mind that it is more effective the sooner it is taken. For this reason it is important that you choose a service that will ensure you can get emergency contraception as quickly as possible.
Feb 1st 2018
Permission given to create Britain's first 'three-person babies'
Doctors in Newcastle have been granted permission to create Britain’s first “three-person babies” for two women who are at risk of passing on devastating and incurable genetic diseases to their children.
The green light from the fertility regulator means that doctors at the Newcastle Fertility Centre will now attempt to make healthy embryos for the women by merging fertilised eggs created through standard IVF using DNA from female donors.
MRT is an experimental treatment that was made legal in Britain in 2015. It aims to prevent serious disorders from being passed to children, caused by mutations in mitochondria, tiny structures that provide energy inside cells. Children inherit all their mitochondria from their mothers. MRT uses healthy donor mitochondria to replace the faulty ones.
The child therefore has the usual 46 chromosomes from its parents, plus additional DNA from the donor's mitochondria. To perform MRT doctors fertilise an egg from the affected woman with her partner's sperm using normal IVF techniques. But instead of letting the egg then develop into an embryo, the chromosomes are taken out and dropped into a healthy donor egg that has had its own chromosomes removed.
The resulting embryo now has DNA from both parents, as usual, plus mitochondrial DNA from the donor.
The Human Fertilisation and Embryology Authority (HFEA) confirmed on Thursday that it had approved the procedures which will now be overseen by Mary Herbert, professor of reproductive biology, and her team at the Newcastle clinic.
The women will be the first in Britain to have so-called mitochondrial donation therapy, a radical IVF procedure that was made legal by parliamentary vote in 2015. The Newcastle centre was granted a licence to perform the treatment, also known as mitochondrial replacement therapy, in March last year
While doctors at Newcastle Fertility Centre said they could not to talk about the cases, citing patient confidentiality, minutes from the HFEA’s approval committee reveal that the two women carry mutations in a gene that causes a rare condition known as myoclonic epilepsy with ragged red fibres, or Merrf syndrome. No more details are given on the women because both wish to remain anonymous.
Merrf syndrome can be a devastating neurodegenerative disorder that worsens over time and often results in an early death. The condition, which affects one in 100,000 people, is typically diagnosed in early childhood or adolescence when people develop sudden spasms which progress to a loss of muscle control, weakness, deafness and dementia.
Having reviewed the women’s medical and family histories, the HFEA committee agreed that any children they conceived may be affected by “serious multi-systemic and progressive disease” which would severely affect their quality of life. Neither woman was deemed suitable for an IVF procedure called pre-implantation genetic diagnosis (PGD), which can pick up harmful mutations in IVF embryos, but can only help if at least some of the embryos are healthy.
Salvatore DiMauro, an expert in mitochondrial disease at Columbia University in New York, said he was glad to hear that Newcastle was going ahead with the procedure to help the women. “It’s good to do this. Merrf is a crippling disease. It’s the only way to be sure it is not passed on,“ he said.
The vast majority of a person’s genes – about 99.8% – are found on the 23 pairs of chromosomes that sit inside the nucleus in each cell in the body. The women who will be treated in Newcastle carry mutations in the small amount of extra DNA that is bundled up in their mitochondria, the tiny battery-like structures that surround the cell nucleus in their thousands. While men and women both have mitochondria, they are passed solely from mother to child. Mutations in mitochondrial DNA cause thousands of genetic diseases that tend to hit the energy-hungry brain, heart and muscles, and worsen with age.
The two women in Newcastle will not be the first in the world to have the therapy. In 2016, John Zhang, a doctor at the New Hope Fertility Center in New York, announced the birth of an apparently healthy child created in a similar way at a clinic in Mexico. While news of the birth was welcomed by many scientists, some voiced concerns that the child might not have the regular follow-up checks that are needed to ensure it is developing properly.Mitochondrial donation therapy was pioneered at Newcastle by the neurologist Doug Turnbull to prevent women passing on harmful mitochondrial DNA mutations to their children.
To perform the procedure, doctors create a fertilised egg using IVF as normal. But rather than letting it develop into an embryo, the parents’ chromosomes are removed and placed inside a donor egg that has had its own genetic material removed. The embryo so created has all of the parents’ chromosomes, but the mother’s damaged mitochondria are replaced with the donor’s healthy ones. Doctors in Newcastle did not confirm whether they had already performed the procedure.
Professor Sian Harding, director of the British Heart Foundation Imperial Cardiac Regenerative Medicine Centre in London said Britain had reached the point of treating women with mitochondrial donation therapy “after a very thorough public consultation process”.
“It is absolutely fantastic that we have got to this point in such a well-regulated and controlled way,” she added. “It is going to be so important now to follow up and understand whether this is successful and how we can take it forward. If you don’t follow up the children, we just won’t know whether this is the right thing to do.”
An HFEA spokesperson said: “Our statutory approvals committee has considered applications from the Newcastle Fertility Centre at Life, part of Newcastle upon Tyne Hospitals NHS Foundation Trust, for the use of mitochondrial donation in treatment for two patients, both of which have been approved.”
Jan 31st 2018
Following this one diet may boost women's chances of pregnancy through IVF
Women who are hoping to get pregnant through in vitro fertilisation (IVF) may significantly improve their chances of success by following a Mediterranean diet.
That's according to scientists at the University of Athens, who found that women following this style of eating in the six months before beginning fertility treatment had a much higher chance of becoming pregnant and giving birth successfully than those who did not.
In the study, which was published today in the journal Human Reproduction, scientists asked 244 women about their diets before they went through IVF.
And those who most closely followed the Mediterranean diet – which is characterised by lots of fresh vegetables, fruit, whole grains, legumes, fish and olive oil, as well as a reduced amount of red meat – had a 65-68% greater chance of having a successful pregnancy and birth than those participants with the lowest adherence to this style of eating.
'The important message from our study is that women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may help increase the chances of successful pregnancy and delivering a live baby,' said study leader Professor Nikos Yiannakouris in a release.
In fact, the team believe that both partners should consider following the Mediterranean diet while attempting to conceive through IVF.
'It should be noted that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women,' he continued.
'Previous work from our research group among the male partners of our study has suggested that adherence to the Mediterranean diet may also help improve semen quality.
'Taken together, these findings highlight the importance of dietary influences and diet quality on fertility, and support a favourable role for the Mediterranean diet on assisted reproduction performance.'
Dec 26th 2017
Eight lies we all still believe about fertility
There are too many myths surrounding fertility and falling pregnant. Here, with a little help from the experts, we attempt to bust some of the biggest...
Myth 1: A woman's fertility drops drastically at 30
Women are led to believe that putting off having a baby until their 30s is risky business. But is it really that much harder to conceive when you're 28 than when you're 32? Dr Geetha Venkat, director of Harley Street Fertility Clinic, says:
'Ovarian reserve and egg quality keep declining as a woman gets older, but it's a gradual process – it doesn't just happen overnight. Your eggs don't go rotten at the stroke of midnight on your 30th birthday! However, we do always encourage people to start their families when they are young as younger eggs tend to be healthier.'
Dr Venkat says that while the drop in fertility between the ages of 30 and 35 is on a gentle curve, the decline is sharper when a woman hits 40 – and sharper still after your 42nd birthday.
Myth 2: All women ovulate on day 14
No two cycles are exactly the same: yours could be 28 days long, while your best friend's is 32. So why would you both ovulate on day 14? It's simple – you wouldn't. Dr Ernesto Bosch, from the world-renowned IVI fertility clinic in Spain, says that the highest probability of ovulation is between days 12 and 18:
'Many couples that are trying to conceive pin their hopes on having sex on one day of the month, thinking that's the best chance of conception. It's much more effective to have sex every day between days 12 and 18.'
Myth 3: Men can have healthy babies at any age
A quick glance at any newspaper or magazine will reveal an article about modern women leaving motherhood too late, while we all assume men can wait their whole lives to become dads. Not true: a 2014 study showed that children born to fathers over the age of 45 are 13 times more likely to have ADHD, 3.5 times more likely to have autism, and 25 times more likely to have bipolar disorder. Just this year, Dr Kevin Smith from Abertay University in Dundee called for all men to freeze their sperm at 18 to avoid adverse health outcomes in their babies. Children of older fathers are also twice as likely to drop out of school early and have low IQs. Plus, a woman is more likely to miscarry if her partner has sperm with highly fragmented DNA – which occurs in older men. Dr Geetha Venkat, says,
'My message to all men is if you want to have a healthy baby, don't think you can start at the age of 70.'
Myth 4: Taking the Pill affects your future fertility
Mr Mostafa Metwally, a consultant gynaecologist at BMI Thornbury, says
'The Pill doesn't harm fertility in any way. While you're taking the Pill, you stop ovulating, but this effect is limited to the time you're taking the Pill and it doesn't harm your eggs. Occasionally, it can take a few months for you to start ovulating again after coming off the Pill, so it may take a few months for you to get pregnant.'
Indeed, recent studies show that 80% of woman who want to conceive after coming off the Pill do so within a year – the same proportion as that of the general population. But Mr Metwally does add, 'If you have a condition that affects your fertility, such as polycystic ovaries (PCOS), the Pill can mask the symptoms of irregular periods, and you won't know you have it.' Dr Venkat adds that if you have the symptoms of PCOS and want to go on the Pill to correct your hormone imbalance, you must be counselled on this fact and should be told that it may take longer to conceive when you do come off the Pill.
It's important that women do not view breastfeeding as a contraceptive
Myth 5: You can't conceive while breastfeeding
You don't have a period, so you can't get pregnant – right? Nope. Mr Metwally says that when you're breastfeeding, levels of a hormone called prolactin, which is responsible for milk production, are raised and this stops the ovaries from producing an egg each month. However, when you've been breastfeeding for a while – a few months – your levels of prolactin go up and down in spikes, so an egg could escape. This can even happen without you having a period. Then the next thing you know, you're pregnant! 'It's important that women do not view breastfeeding as a contraceptive,' says Mr Metwally.
Myth 6: We're all born with the same number of eggs
Although each woman is born with the total number of eggs she'll have throughout her lifetime, that number is not the same for all women. In 2012, researchers found that if your mother starts menopause early (before age 45), your ovarian reserve – or how many eggs you've got left stored up – is depleted quicker than if she had started menopause later. But before you go into panic mode about your diminishing egg stores, Mr Metwally points out that it is the quality of eggs that matter and not quantity.
'Women shouldn't use an ovarian reserve test to determine when they should have babies, as it doesn't tell you anything about the quality of your eggs. Someone who's 40 when they come in for fertility treatment may have a lower success rate than someone of the same age with a lower ovarian reserve, but this is because their eggs may be of a lower quality.'
Myth 7: There are contraceptive pill hormones in our drinking water
Scaremongering in the press has led us to believe that our increased use of the contraceptive Pill has contaminated our drinking water with synthetic hormones. Some news reports have gone as far as comparing the potential effects to those of the thalidomide controversy or mad cow disease.
However, in 2011, Tracey Woodruff and her team at the University of California in San Francisco published a report in Environmental Science and Technology that debunked the synthetic hormone in water myth. They found that the amounts of synthetic hormone – namely oestrogenic compounds – leaked into waterways from the Pill are negligible. In fact, crop fertilisers, hormones form livestock, chemicals, medications, pregnant women and wait for it – men – are just as likely to contribute natural or synthetic oestrogen to our water than the Pill.
Myth 8: Sperm allergy = no pregnancy
Human seminal plasma hypersensitivity – or being allergic to semen – may cause genital itching, burning and swelling after sex (apart from when you use a condom) but it doesn't mean you have to ignore your dreams of having a family. Desensitisation therapy, which involves treatment with allergy injections containing small amounts of your partner's sperm and having sex two or three times a week to get your body used to the sperm, can help. Interesting fact: the first successful pregnancy by insemination in a woman with sperm allergy was in 1981 – she had twins.
Dec 14th 2017
An IVF baby was born with cystic fibrosis after its parents were mistakenly identified as not being carriers of the condition, according to a report.
The Human Fertilisation and Embryology Authority (HFEA) said the grade A incident, the most severe, took place after screening results from a pathology laboratory were not properly read by the treating clinician, and were not signed and transposed into the patients’ medical records.
The case was detailed in the HFEA’s first 'state of the sector' report, which contained largely positive news about IVF in the UK.
It said the number of women who have twins, triplets or more following IVF treatment has reduced from nearly one in four in 2009 to one in 10, described as a 'fantastic' achievement which has increased the safety of the procedure for mothers and babies.
The drop in multiple births has also reduced the burden on NHS antenatal and neonatal services, the Government’s independent regulator overseeing fertility treatment and research said.
But it added that 'some areas for concern' included that the number of reported adverse incidents increased last year, from 497 in 2015 to 540.
Of these, 325 were categorised as grade C and 176 were grade B, with just the one grade A incident in 2016.
Other findings from that incident were that there was no robust system providing evidence that reports are reviewed by the treating clinician or nurse before being filed.
The clinic, which was not named, did not have a standard operating procedure to ensure reports are allocated to the appropriate member of staff for review.
It added that changes have been implemented since.
The HFEA said that through working with licensed clinics in the UK, it has reduced the national multiple birth rate from 24% in 2009 to 11%. This has come without a reduction in birth or pregnancy rates, with the latter rising from 24% in 2008 to 32%.
Multiple births are the greatest risk associated with fertility treatment.
At least half of twins are born premature and underweight, which can lead to serious health problems and even death.
Mothers are far more likely to have an early or late miscarriage if they are carrying multiple babies and are more likely to suffer from health problems such as high blood pressure, gestational diabetes, anaemia and haemorrhage.
More than 76,000 cycles of IVF were carried out in 119 licensed fertility clinics across the UK in 2016/17.
Three in five treatments (60%) were paid for by patients themselves.
There are 132 treatment and research clinics working under licence in the UK, of which 34% are privately run, 29% are in public/private partnership, and 22% are NHS only, according to the report. The remaining 15% are research only.
NHS Choices estimates that around one in seven couples in the UK have trouble conceiving, around 3.5 million people.
IVF success rates depend on how old the woman is, ranging from 32.2% of treatments resulting in a live birth for women under the age of 35 in 2010, to just 5% for women aged 43 to 44.
The National Institute for Health and Care Excellence (Nice) recommends eligible patients should have access to three rounds of IVF funded through the NHS, but just 12% of local health bodies offer this many cycles. Others offer one or two cycles and some offer none at all.
Costs vary but they can be around £5,000 for one cycle.
HFEA chairwoman Sally Cheshire said the report 'outlines the importance of us working together to ensure patients, donors and the donor-conceived get the highest possible quality care'.
Nov 26th 2017
Females' Eggs May Actively Select Certain Sperm
New evidence challenges the oldest law of genetics.
In the winner-takes-all game of fertilization, millions of sperm race toward the egg that’s waiting at the finish line. Plenty of sperm don’t even make it off the starting line, thanks to missing or deformed tails and other defects. Still others lack the energy to finish the long journey through the female reproductive tract, or they get snared in sticky fluid meant to impede all but the strongest swimmers. For the subset of a subset of spermatozoa that reach their trophy, the final winner would be determined by one last sprint to the end. The exact identity of the sperm was random, and the egg waited passively until the Michael Phelps of gametes finally arrived. Or so scientists have thought.
Joe Nadeau, principal scientist at the Pacific Northwest Research Institute, is challenging this dogma. Random fertilization should lead to specific ratios of gene combinations in offspring, but Nadeau has found two examples just from his own lab that indicate fertilization can be far from random: Certain pairings of gamete genes are much more likely than others. After ruling out obvious alternative explanations, he could only conclude that fertilization wasn’t random at all.
“It’s the gamete equivalent of choosing a partner,” Nadeau said.
His hypothesis—that the egg could woo sperm with specific genes and vice versa—is part of a growing realization in biology that the egg is not the submissive, docile cell that scientists long thought it was. Instead, researchers now see the egg as an equal and active player in reproduction, adding layers of evolutionary control and selection to one of the most important processes in life.
“Female reproductive anatomy is more cryptic and difficult to study, but there’s a growing recognition of the female role in fertilization,” said Mollie Manier, an evolutionary biologist at George Washington University.
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The idea of sexual selection is as old as Charles Darwin himself. In On the Origin of Species, he wrote of the peacock’s showy tail and the elk’s giant antlers as examples of traits that evolved to help males show off their appeal as mates to females. For the next century, biologists focused on all the aspects of sexual selection that operated in the events leading up to copulation. After mating, the female had made her choice, and the only competition was among the sperm swimming to the egg.
This male-oriented view of female reproductive biology as largely acquiescent was pervasive, argued Emily Martin, an anthropologist at New York University, in a 1991 paper. “The egg is seen as large and passive. It does not move or journeybut passively ‘is transported’ ... along the fallopian tube. In utter contrast, sperm are small, ‘streamlined,’ and invariably active,” she wrote.
“There are incredible things that eggs and seminal fluid can do.”
Beginning in the 1970s, however, the science began to undermine that stereotype. William Eberhard, now a behavioral ecologist at the Smithsonian Tropical Research Institute, documented all the ways that females can affect which males fertilize their eggs even after mating. It’s a long list, and scientists still can’t say for sure whether they’ve documented everything. The belatedness of these discoveries wasn’t all due to sexism. Two walruses dueling with their tusks is easy to observe; games of hide-and-seek with sperm inside the female reproductive tract are much less so.
“As soon as you have eggs and sperm, you have sexual selection. There are incredible things that eggs and seminal fluid can do,” explained Andrea Pilastro, an evolutionary biologist at the University of Padova in Italy.
In those species in which fertilization happens outside the body, the females often coat their eggs with a thick, protein-rich ovarian fluid. Experiments in 2013 by Matthew Gage of the University of East Anglia in England showed that this fluid contains chemical signals to help attract the correct species of sperm. When they exposed eggs from salmon and trout to mixtures of sperm from both species, the eggs’ own species successfully fertilized 70 percent of the time, significantly more than to be expected by chance.
“The sperm behaved differently in different ovarian fluids. They actually swam straighter in their own fluid,” Gage said.
Internal fertilizers have their own methods of what Eberhard dubbed “cryptic female choice.” Some female reproductive tracts are labyrinthine, complete with false starts and dead ends that can stymie all but the strongest sperm. Some females, including many species of reptiles, fish, birds, and amphibians, that copulate with more than one male (which biologists estimate are a vast majority of species) can store sperm for months, even years, altering the storage environment to stack the odds to favor one male over another. Many female birds, including domestic chickens, can eject sperm after mating, which lets them bias fertilization in favor of the best male.
All these strategies, however, provide females with opportunities only to select the sperm of different males. Within an ejaculate, which sperm fertilized the egg still seemed to be left to chance.
“We’ve been blinded by our preconceptions.”
In fact, the randomness of fertilization is implicit in the principle of segregation—the first law of genetics going back to Gregor Mendel. Parents carry two copies of each gene, which are divided randomly into gametes that carry only one copy. It’s what gives rise to many of the probabilities students learn in high-school biology. If both parents are heterozygotes—meaning they carry two alternate versions of the same gene—then half their offspring would also be heterozygotes. A quarter of the offspring would be homozygotes carrying two copies of one version, and the remaining quarter would be homozygotes with the other version.
“It’s one of the most broadly applicable rules in biology,” Nadeau said.
Yet these probabilities work out only if fertilization is random. If the egg or the sperm can somehow influence the identity of the other gamete involved in fertilization, then those ratios could be very different. This striking difference was what caught Nadeau’s attention back in 2005. When he started looking at the inheritance of two particular genes in mice, the probabilities were all off. In his Seattle lab, he began to wonder: Could Mendel have been wrong?
* * *
Nadeau hadn’t set out to question Mendel. Instead, he wanted to know how interactions between two genes (Apobec1 and Dnd1) affected risks for testicular cancer, one of the most heritable forms of cancer. When Nadeau and his doctoral student Jennifer Zechel bred female mice carrying one normal and one mutant copy of Dnd1 with heterozygote Apobec1 males, everything appeared to follow Mendel’s rules. So far, so good. But when they reversed the breeding (a female Apobec1 heterozygote mated with a male Dnd1 heterozygote), things got weird: They found that only 27 percent of the expected offspring carried copies of mutant Apobec1, mutant Dnd1, or both, compared with the 75 percent they expected to see.
As a researcher who had spent several decades studying heredity, Nadeau was aware of myriad factors that could affect Mendel’s ratios. If a fertilized egg ended up with two mutated copies of a recessive gene, the resulting embryo might die early in development. Such embryonic lethal mutations would alter the ratio of homozygotes to heterozygotes, but it would also reduce the average number of mouse pups in each litter. Yet all of Zechel and Nadeau’s mice had standard litter sizes, and they found no evidence that embryos were dying early after fertilization.
Perhaps, Nadeau reasoned, the problem lay in the sperm, not the egg. He therefore bred male mice with and without the mutation to healthy mutation-free females and found no differences in the males’ fertility—something that would have become obvious if the mutation were affecting sperm formation. Step by step, Nadeau and his team eliminated every possible cause of these wonky ratios of offspring genotypes ... except one: that during fertilization, the egg and sperm were genetically biased against the mutant genotype.
Surely, someone else must have already seen this, Nadeau reasoned, so he searched the scientific literature. Although he could find plenty of examples of unexplained offspring ratios, no one had seriously pursued genetically biased fertilization as an answer.
“I don’t think we still really appreciate how common this is and how often it happens.”
“Everyone just interpreted it as embryonic lethality because we see what we look for and we explain it using what we know,” Nadeau said.
One of those examples Nadeau found was from the lab of the cancer researcher Roseline Godbout at the University of Alberta. Godbout studied the role of a protein called DDX1 in the development of retinoblastoma, a highly heritable childhood cancer. Mice that were missing one functional copy of the DDX1 gene (but with another, fully functional gene as backup) seemed normal and healthy. When Godbout and Devon Germain, now a postdoctoral fellow at the Max F. Perutz Laboratories in Vienna, bred such heterozygote males and females, they found that none of the offspring lacked both copies of DDX1, even though simple Mendelian math would suggest 25 percent of them should. Given the gene’s importance to DNA replication, however, this wasn’t surprising: The homozygotes without DDX1 presumably died after conception. Godbout and Germain also found lower-than-expected numbers of homozygote offspring with two copies of DDX1. A complicated series of mating experiments led the scientists to propose that their results came from a rare mutation that had occurred in the DDX1 gene during their experiments.
Nadeau wasn’t convinced. He wrote to Godbout to ask how her lab had verified that the “knockout” homozygotes without DDX1 genes had died as embryos. They hadn’t. He also asked whether they had considered genetically biased fertilization, wherein the egg preferred to fuse with a sperm of the opposite DDX1 genotype.
“We really thought it was just a weird pattern of inheritance,” Germain recalled. “We hadn’t thought about nonrandom fertilization.”
Later, on a whim, Germain decided to review all the raw data from his experiments. As he looked over the results, he remembered Godbout’s questions that had been prompted by Nadeau’s email. The more he looked at the data, the more that genetically biased fertilization looked like “the most plausible explanation,” he said.
Frustrated at how few scientists had seriously considered genetically biased fertilization as an explanation for their results, Nadeau wrote up his hypothesis in “Can Gametes Woo?,” an article published in October in Genetics. His goal, he said, was to spur more research into this area and determine if and how egg-and-sperm interactions can alter fertilization.
“We’ve been blinded by our preconceptions. It’s a different way to think about fertilization with very different implications about the process of fertilization,” Nadeau says.
Other scientists, such as Manier at George Washington University, say that Nadeau’s hypothesis is intriguing and even plausible, but they point out that no one has any evidence about how it could happen. Nadeau agrees and points to two possibilities.
“Females are going to have a vested interest in the outcome of fertilization.”
The first involves the metabolism of B vitamins such as folic acid, which form important signaling molecules on sperm and eggs. Research in Nadeau’s lab has shown that these molecules play an outsize role in fertilization, and he believes abnormalities in certain signaling genes may alter how much sperm and egg attract each other.
A competing hypothesis builds on the fact that sperm are often present in the female reproductive tract before the final set of cell divisions that produce the egg. Signals from the sperm could influence these cell divisions and bias the identity of the cell that becomes the egg.
Whatever the mechanism might be, this work challenges the standard view of female physiology as passive during fertilization. “Females were seen as passive objects with no choice, but females are going to have a vested interest in the outcome of fertilization,” said Renee Firman, an evolutionary biologist at the University of Western Australia. “We still have a long way to go to understand this process, but I don’t think we still really appreciate how common this is and how often it happens.”
Finding data to support or refute this hypothesis could be challenging, Manier said. It will depend on showing that genes within the sperm affect their surface molecules, and that the egg can sense these differences. Such results will require detailed biochemical studies of individual sperm cells and sequencing information about their genome.
Nadeau is prepared for skeptics—he’s encountered many at conferences when he presents the results of his mouse studies and his hypothesis for what’s going on. Critics often approach him after the talk and begin asking him questions. Whether they walk away convinced is unclear, but Nadeau feels they are much less certain that biased fertilization doesn’t happen. To Harmit Malik, a geneticist and virologist at the Fred Hutchinson Cancer Research Center, the situation is the ultimate Sherlock Holmesian solution.
“If you’ve eliminated the impossible, then what remains, however unlikely, must be the truth,” he quipped.
Sept 15th 2017
Nearly half a million people in the UK are diagnosed with a sexually transmitted infection (STI) every year. But what many don't realise is that some STIs can affect your fertility. In fact, as many as a quarter of all infertility cases are thought to be linked to an STI.
Here are some common issues associated with STI's and fertility:
1.Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection in the upper genital tract and can be either asymptomatic or symptomatic. It is a serious condition because it can permanently damage the uterus and the fallopian tubes. However, if PID is mild and treated early, your chances of conceiving are high. Sadly, if you have severe PID or it goes untreated, the chances of your tubes becoming blocked are higher. It's estimated that one in five women with PID have fertility problems.
2.Chlamydia and gonorrhoea
Both infections present absolutely no obvious symptoms at all, so you might not even realise that you're infected. Therefore, it's extremely important to get tested regularly - the longer you're infected with chlamydia or gonorrhoea, the greater the likelihood that these infections will damage your fallopian tubes and future fertility. It also means that you may be inadvertently infecting a partner, impacting their future fertility as well.
In most cases, the herpes virus does not affect either a woman or a man's ability to conceive. However, the biggest detriment that herpes will have on a couple's fertility is the need to abstain from intercourse during an outbreak in either partner. This can limit their chances of conceiving depending on how long the outbreak is and how often they experience 'flare ups'.
The negative impact of chlamydia on male infertility is often underestimated. Chlamydia in men can damage sperm and cause scarring in the reproductive tract (which can lead to permanent infertility). It is estimated around 25 - 50% of all male chlamydia cases go completely unnoticed.
5. Fallopian tube damage
Scarring or damage to the fallopian tubes can cause what is referred to as "tubal infertility
": Many cases of tubal disease are caused by infection such as pelvic inflammatory disease (PID). Scarred and damaged fallopian tubes can prevent sperm from reaching and fertilising the egg. If an egg does get fertilised, blocked tubes can also keep that fertilised egg from reaching the uterus. This can increase your odds of having an ectopic pregnancy - when the embryo implants in the fallopian tube wall, rather than in the uterus wall.
Dr Venket is the director at Harley Street Fertility Clinic
Sept 14th 2017
When online pharmacy Chemist 4 U revealed that they would be selling the morning after pill to women for just £4.99 per pack, the news polarised opinions.
Initially, the UK website was praised for its progressive move – being the first to make the pill available to buy online at such an affordable price tag.
However, campaigners on reproductive ethics have been quick to condemn the initiative, explaining that the accessibility presents the morning-after pill as custom contraception, when doctors advise only taking it in emergencies.
The online retailer is offering customers the opportunity to bulk buy a generic version of Levonelle, a well-known form of the morning-after pill.
Women will be able to buy as many as three packs of the pill in six months – whereas it has previously only ever been sold individually, after in-store consultations at high street pharmacies.
In some cases, the pill can be obtained for free on the NHS and at some sexual health clinics.
Now all it takes is an online form which is reviewed by a Chemist 4 U medic before distributing the drug at what Josephine Quintavelle, from Comment on Reproductive Ethics, calls “pocket money prices,” reports The Telegraph.
She explained that the low price tag raises moral concerns as it misleadingly normalises the act of taking the morning after pill so that it becomes all-too-casual a process when in fact, taking the pill, particularly more than a few times, comes with a slew of risks.
Experts have always strongly advised that women shouldn’t take it on a regular basis, though some have argued that Chemist 4 U’s “advanced supply” initiative inadvertently advocates doing so.
"They sell the product as an 'advance' purchase, ensuring a customer has a product on their shelf in case of emergencies," a spokesperson for Chemist 4 U told The Independent.
“We always advise women in an emergency situation, to go to their nearest pharmacy that day, rather than waiting a day to receive it from an online pharmacy," explained Chemist 4 U's managing director, Shamir Patel.
"However our belief is, an advanced supply from us avoids the panic in the unlikely event of barrier method failure. We advise all patients that EHC should not be used as a regular contraceptive method,” he said.
The initiative comes after Boots and Superdrug drastically reduced prices of the pill sold in store – with Superdrug’s dropping from £27 to £13.49. Tesco also sell it for £13.50.
However, the price reductions were not without controversy either. Initially, after the British Pregnancy Advisory Service urged high street retailers to drop prices of the morning after pill, Boots refused, claiming that it would encourage women to “abuse” it and that it might promote “inappropriate use.”
Alas, Boots ultimately retracted their claims and reduced the price of the pill from £26 to £15.99.
Aug 26th 2017
Flame-retardant chemicals used on furniture and other products could be making women infertile, a new study suggests.
Researchers in the US found more than 80 per cent of women having fertility treatment at the Massachusetts General Hospital had traces of three types of chemicals known as PFRs in their urine.
And those with high levels of the chemicals were 38 per cent less likely to have a child after a cycle of IVF treatment than those with low levels.
While the study does not prove the chemicals are causing infertility, it highlights a possible link.
One of the researchers, Dr Courtney Carignan, said: “These findings suggest that exposure to PFRs may be one of many risk factors for lower reproductive success.”
“They also add to the body of evidence indicating a need to reduce the use of these flame retardants and identify safer alternatives.”
And her colleague at Harvard Unviversity’s school of public health, Professor Russ Hauser, said the evidence was strong enough to make prospective parents think about trying to avoid exposure to the chemicals.
“Couples undergoing IVF and trying to improve their chances of success by reducing their exposure to environmental chemicals may want to opt for products that are flame-retardant free,” he said.
PFRs were introduced as flame retardants as a supposedly safer alternative to PentaBDE after evidence of its adverse health effects.
However concern has been growing about PFRs – organophosphate flame retardants – which are used in polyurethane foam in upholstered furniture, baby products and gym mats, for example. They can spread from furniture into the air and dust of rooms.
This adds to something of a cocktail of hormone-disrupting chemicals in modern houses, a problem that can be exacerbated by a lack of effective ventilation. Pesticides and phthalates, which are used to make plastic more flexible in a whole host of products, have also been linked with reproductive problems.
Commenting on the new study, Professor Richard Anderson, an expert in clinical reproductive science at Edinburgh University, said: “There is growing concern that the chemicals we are all exposed to may have an impact on fertility, but direct evidence of impact in men and women has often been limited.
“This carefully conducted study analysed chemicals from flame retardants in urine from women having IVF, and found that the chemicals were detected in most women.
“Worryingly, higher concentrations of these chemicals were associated with substantial reductions in the success of IVF, with a lower chance of having a baby.”
He said this method of studying the effects of chemicals on fertility was a good one.
“Studying couples having IVF is a powerful way of carrying out analyses such as this, as it allows each of the steps in conception and pregnancy to be examined, which isn’t possible in natural conception,” he said.
“While this study doesn’t prove that these chemicals are the cause of the lower success rate, it provides a firm basis for further experiments to investigate them.
“It also provides strong support for the need to regulate our exposure to chemicals and test their potential impact on fertility.”
Professor Allan Pacey, of Sheffield University, said the data obtained by the Harvard researchers “seems fairly convincing” and supported the idea of “a link between a woman’s exposure to these flame-retardant chemicals and her chances of getting pregnant”.
However, he also stressed that it did not prove this.
“We should be sensitive to the fact that the urinary metabolite concentration of these chemicals in this study could be a surrogate marker for another aspect of the woman’s lifestyle that is actually causing the effect observed,” he added.
“Ultimately, we need to keep our lives safe from fire and so before men and women undergoing IVF throw away their yoga mats, I think we need a bit more data in larger populations and in various parts of the world.
“We also need some more details about the likely mechanism by which these chemicals could be causing such an effect.”
A paper about the study was published in the journal Environmental Health Perspectives.
April 19th 2017
The contraceptive pill can reduce the general well-being of healthy women, a study has claimed.
Researchers at the Karolinka Institutet in Sweden and the Stockholm School of Economics studied 340 healthy women aged between 18 and 35. The women were either given prescriptions for a combined contraceptive pill containing ethniylestradoil and levonorgestrel (the most common type of contraceptive pill in the country and many others) or a placebo pill.
Neither group knew which pill they were taking but the women who were given contraceptive pills estimated their quality of life to be “significantly lower” than those taking the placebos. The women said their general well-being, along with their moods, self-control and energy levels, were all negatively affected by the pill.
However, despite these side effects the study suggested there was no significant increase in depressive symptoms.
The researchers emphasised that as the changes were relatively small, the results must be interpreted with caution but said the negative effects on the quality of life in individual women may be of clinical importance.
“This might in some cases be a contributing cause of low compliance and irregular use of contraceptive pills,” the study’s co-author Niklas Zethraeus said. “This possible degradation of quality of life should be paid attention to and taken into account in conjunctions with prescribing of contraceptive pills and when choosing a method of contraception.”
The authors said the findings could not be generalised to other kinds of combined contraceptive pills as they may have a different risk profile and side-effects.
Last year, a particularly large study suggested a link between women who take the pill and an increased risk of developing depression. The study analysed one million Danish women and found the combined oral contraceptive increased the risk of a woman aged between 20 and 34 being prescribed antidepressants by 23 per cent. For teenage women aged between 15 and 19, the risk of depression was 80 per cent and 120 per cent for those taking the progestogen-only pill (mini pill).
April 11th 2017
A man who froze his sperm more than two decades ago before having twins with his partner has claimed a world record.
The Scottish musician, who did not want to be named, had his sperm frozen when he was 21 before starting chemotherapy treatment for cancer, as doctors warned him he would become infertile.
After his sperm was kept in cold storage for 26 years and 243 days, his partner underwent in-vitro fertilisation in 2010.
“It’s quite a big deal for a woman to take that on,” he told The Times.
The couple gave birth to a girl and a boy the following year. He was 47, and his partner was 37.
Now 54, he knew he held a world record, but did not want to go public.
The previous world record holder, Alex Powell, had his sperm frozen for 23 years and the story was reported around the globe. He was also about to undergo chemotherapy.
But the musician learnt he could be listed anonymously in the Guinness Book of Records, and he agreed to speak to one newspaper to highlight how long sperm can be frozen and used to produce healthy children.
“For people going through chemotherapy, they should keep hope," he said.
Marco Gaudoin, director of the GCRM medical clinic where the treatment took place, said that frozen sperm could theoretically be stored “indefinitely”.
The Human Fertilisation and Embryology Authority claims sperm can be frozen for more than 40 years, but not all sperm survive the process.
It has to be frozen for at least six months before it can be used for treatment, to screen the donor for infections.
Sept 26th 2016
Women in UK can now use an app dubbed 'order a daddy' to pick a sperm donor
A mobile app has been launched that allows women to select a sperm donor based on characteristics including race, nationality and eye colour.
London Sperm Bank Donors, dubbed the "order a daddy" app, allows users to narrow down their search and browse through potential fathers and create a "wish list" alert that informs them when a donor with their desired characteristics becomes available.
The search function on the app provides a list of potential fathers - titled by number such as "Donor 1000" and Donor 1004" - with their physical characteristics listed below.
The user can then choose to "Find out more", which brings up more detailed information about the donor, including medical information, personality and a written description of their characteristics.
The description gives an insight into what the donor is like. One states: "Pleasant, charming and easy to get on with, this donor was a cheerful intellectual teeming with positivity," while another reads: "He is a well mannered, well spoken and very likeable individual".
Applicants listed are from a wide range of professions including law, medicine, finance, engineering, hospitality, the performing arts and creative work.
Users can buy a donor's sperm sample by making payment of £950 via the app, and the sample is then delivered to the fertility clinic where the woman is being treated.
The app, which promotes itself as a way to "Plan your family on the go", is legal and meets the requirements of the Human Fertilisation and Embryology Authority (HFEA), the IVF regulator. About half of Britain's IVF clinics are said to have registered to use the service.
Critics have claimed the app trivialisesparenthood. JosephineQuintavalle, of the campaign group Comment on Reproductive Ethics, told The Times: “How much further can we go in the trivialisation of parenthood?
“This is reproduction via the mobile phone. It's digital dads. Choose Daddy. This is the ultimate denigration of fatherhood.”
But Dr Kamal Ahuja, scientific director of the London Sperm Bank, said the app was in keeping with the rise in online transactions, saying: “You make all the transactions online, like you do anything else these days.
"This allows a woman who wants to get a sperm donor to gain control in the privacy of her own home and to choose and decide in her own time. We think this is the first of its kind in the world.”
Sept 14th 2016
A little girl born with feet the size of a fingernail is being hailed as the world's smallest surviving premature baby.
Emilia Grabarczyk was only 8.6 inches (22cm) long and weighed 8 ounces (229 grams) when she was born at a hospital in the western German city of Witten nine months ago.
Her tiny foot was only 1.2 inches (3cm) long.
In comparison, a large banana weighs about 7 ounces while an orange is 6 ounces.
Doctors have described her as the "little fighter" and her survival as a "medical sensation" while German media said she was the lightest premature baby ever born in the world.
The early birth was followed by a period of uncertainty. Emilia was born so early that it led to subsequent complications.
There was an increased risk of hyperactivity and learning difficulties. Emilia even survived abdominal surgery at a weight of just 12 ounces.
Yet luckily for the girl, there are no signs of serious disability.
She was initially fed with a tiny tube. The doctors used a cotton bud soaked in sugar water to soothe her and relieve pains.
Her birth at the Maria Hospital came after doctors decided with her parents Lukas, 34, and Sabine, 30, to deliver the baby by Caesarean section at the 26th week of pregnancy.
The record for the smallest baby was said to be held by Rumaisa Rahman, who was born in the Loyola University Medical Centre in the US city of Chicago in 2004 when her mum was only 25 weeks pregnant.
At birth, Rumaisa was 8 inches tall and weighed 8.6 ounces.
Professor Dr Sven Schiermeier, chief physician of obstetrics, said that Emilia would have died in the womb if they hadn't delivered her early as the placenta was not sufficient for her nutrition.
For comparison, the doctor said that usually a foetus in the 26th week of pregnancy would have weighed around 21 ounces.
For Lukas and Sabine, there was no question as to whether they would give the child a chance even if the odds for survival were low.
"There were many difficult days and many tears, but she clearly wanted to survive," the mother said.
Right now, Emilia weighs 106 ounces and seems to be in much better physical condition.
Dr. Bahman Gharavi, Head of Children and Youth Clinic at the hospital, said the Emilia's birth was truly unique.
The doctor said that the survival of the baby was only possible thanks to the joint effort of paediatricians, gynaecologists and paediatric surgeons.
"Even children with a birth weight of 14 ounces rarely survive. We have to thank Emilia as well for her own survival," he said.
"She is a little fighter.
"For more than six months, it was unclear whether she would survive. Only in recent weeks she is getting more robust."
Infertility is a very worrying problem for couples who are trying to increase their family but are being unsuccessful for no apparent reason, and it’s not very reassuring when your friends and family say that as soon as you stop worrying about it then it will happen, but there’s a lot truth in that, the wondrous thing that happens when a baby is conceived will only happen when your body decides that you are relaxed enough for motherhood.
Have you ever wondered why female has two ovaries, and are they the same? do they both produce an egg every month? this is unlikely or there would be more twins in the world, they do take turns at releasing an egg? yes they do and what happens if one of the ovaries is not functioning for some reason, does that mean you only get one chance every two months? yes it does. As you can see it’s a very complicated subject that produces more questions than answers.
The first step is a very thorough examination by your medical expert to see if there’s any obvious reason why you are not clicking, if there is nothing obviously wrong with you then will have to consider the health of your partner, if the sperm sample he produces has no obvious defects then will have to turn our attention to the technique and mechanics of your mating.
It is not a good idea to refrain from sex until the particular day that you have calculated to be your best time, there are several reasons for this firstly making this day special increases your stress level and that’s not a good thing if you are trying to be relaxed, it should be a stress free, every day event, well perhaps not every day, there are a few people with that much drive and stamina.
Then we have to consider the health of the little swimmers, there are constantly being produced and if they are not used the body reabsorbs them if they have nowhere to go, it’s obviously much better to use a supply of the freshly produced sperm and frequent ejaculation ensurers that what you’re getting is top quality, or at least as good as it gets.
Apparently female orgasm does not come into this calculation according to Masters and Johnson who have stated there is no indication that this helps the actual conception, or as a state in their book there is no indication of upsuck.
Australian scientists are designing a condom that actually feels goodReplacing latex with prosthetic skin.
FIONA MACDONALD 8 APR 2015 18.2k
It's no secret that a lot of people don't enjoy using condoms. Sure, we appreciate their disease- and pregnancy-preventing benefits, but let's be upfront about the fact that no one really likes to wear them.But there's hope, because scientists at the University of Wollongong in Australia are working with an ultra-tough material called hydrogel that could be used to create condoms that can feel even better than nothing at all.Hydrogels are strong and flexible solids that have been used for decades, but have more recently been engineered to have a range of different properties. One of the most promising is the fact they can be made to feel and act like human tissue, and are already being widely used in prosthetics to create things such as blood vessels and even eye implants.But the Australian team, led by materials scientist Robert Gorkin, decided to take things one step further, and investigate whether hydrogel could replace latex to create condoms that people actually want to use (no offence, latex).University of WollongongThey entered the idea in a recent Bill and Melinda Gates Foundation call-out for a Next Generation Condom, and won one of 52 grants on offer, giving them access to US$100,000 to research the viability of their hydrogel condoms. Nine months on, and things are looking extremely promising, with the material not only able to physically act like a condom, but also able to block biological material.“Our original idea was just to try to prove that an original material could replace latex," Gorkin told ScienceAlert. "We were starting from scratch, we had an idea that these new materials would have the same properties as rubber with a nicer feel, but we weren't sure if they had the right properties for a condom."“The early indications are that the materials are strong enough and actually do prevent against the transfer of small biological molecules," he said. You can see some of their durability tests in action below:Even more impressive is the fact that hydrogels can be engineered to perform all kinds of different functionalities, such as self-lubrication, topical drug delivery, biodegradability and even electric conductivity. For example, imagine a condom that delivers its own dose of Viagra, or responds to stimulation just like human skin. Depending on how you fabricate the material, you can potentially open up a whole new world of pleasure.The team is not just relying on their own opinions on what feels good, however, they're now partnering with Swinburne University of Technology in Melbourne, Australia, to conduct biometric testing that will be able to measure the body's response to the material."We'll be able to look at brain activity to see whether it really feels better than latex," explained Gorkin. "If you make them so pleasurable that people can't wait to put them on, then more people will use them, and we can hopefully stop the spread of disease. It's as simple as that."University of WollongongThe next step is to prove that hydrogel is a potential material for the Gates Foundation Next Generation of condoms, and receive the next round of funding to start making and testing them more broadly. Of course, the aim is to one day be able to create something that does what no condom has been able to do yet - improve uptake and regular use.Although a lot of the focus is on regions such as sub-Saharan African and southeast Asia, the outcome would be just as important in countries such as the US, which, despite having plenty of access to birth control, has the highest rates of accidental pregnancies and HIV transmission in the developed world.Gorkin also wants to look beyond the science and make sure that cultural and social needs for birth control influence how they design their condom. "It's a branding exercise as much as a scientific one," said Gorkin. "A material alone can't change the way we look at sex, but we believe it can definitely help."We're already sold - bring on the future of birth control.Home Page - medical - infertility