The 66th Annual Meeting of the American Society for Reproductive Medicine took place from Oct. 23 to 27 in Denver and attracted approximately 6,000 participants from around the world. The conference highlighted advances in reproductive medicine, with presentations focusing on the effects of hormone level variation, approaches to address infertility and low sexual desire, treating neural tube defects, and understanding the impact of obesity on infertility.
In a retrospective study, Wayne T. Lin, M.D., of the University of California in San Francisco, and colleagues found that women with BRCA1 and BRCA2 mutations may have an earlier age of natural menopause.
"We found that mean age of menopause among women with BRCA mutations was significantly lower than normal population without the mutations," Lin said. "The earlier-onset menopause in BRCA mutation carriers could imply a diminished ovarian reserve as compared with normal population."
The investigators compared the mean age of natural menopause for BRCA carriers to the presumed population mean of 51.4 years, as reported by the Study of Women's Health Across the Nation.
"It is already known that early menopause is related to earlier ending of natural fertility, implying accelerated ovarian aging, diminished ovarian reserve, and subfertility. Therefore, based on the finding of BRCA with earlier menopause, we would recommend to BRCA carriers definitely to stop smoking and to consider earlier childbearing," Lin said. "Options of ovarian reserve testing with good predictivity are available. Doctors taking care of BRCA mutation carriers may consider assessing ovarian reserve with these tests earlier."
In another study, Raymond Farkouh, Ph.D., of RTI Health Solutions in Research Triangle Park, N.C., and colleagues found that adding folic acid to oral contraceptives could reduce neural tube defects. Using national data on baseline levels of folates and the results of a recent clinical trial of folate-fortified oral contraceptives, the investigators estimated the potential benefits to women becoming pregnant within five months of taking a folate-fortified oral contraceptive. They concluded that the increased folic acid levels would decrease neural tube defects between 23.7 and 31.4 percent.
"Women currently using contraception, but who may soon wish to have a child, would seem a natural target for folic acid supplementation. Fortifying birth control pills could be a novel way to increase folic acid levels in women of childbearing age," William Gibbons, M.D., president of the American Society for Reproductive Medicine, said in a statement.
The study was sponsored by Bayer Schering Pharma AG. Two authors disclosed serving as employees of RTI Health Solutions, while another author disclosed serving as a contractor for the company.
In an economic analysis, Nastaran Foyouzi, M.D., of the University of California in San Francisco, and colleagues found that obtaining a karyotype on the products of conception in women after a second miscarriage is more cost-effective than the standard recurrent pregnancy loss (RPL) evaluation. The investigators created a decision model to evaluate the cost-benefit of obtaining a karyotype of the products of conception at the time of a second pregnancy loss.
"According to our analysis for all ages, karyotyping has a cost-benefit, and this benefit increases with age. For example, for women aged 35 to 40, the karyotype strategy has a cost-benefit of $498 per patient when compared to the routine RPL workup strategy. If we add more extensive and commonly used workup to the recommended workup, then the cost for this extensive workup is $5,176, with a cost-benefit of $1,500 for the karyotype strategy," Foyouzi said.
In addition, the investigators aimed to understand how cost-effective each strategy was in its ability to provide patients with an explanation for their loss, comparing the cost of each strategy per definitive diagnosis achieved.
"Our study showed [that], for a 35- to 40-year-old woman, the basic RPL workup costs $10,016 per diagnosis, while the karyotype strategy costs $4,654. So there is a cost-benefit of about $5,000 per diagnosis achieved when using the karyotype strategy," Foyouzi said. "Therefore, we recommend obtaining a karyotype of the products of conception for all patients with a second pregnancy loss. This strategy may be particularly beneficial in women over the age of 35."
ASRM: Hormone Levels Tied to Woman's Emotional Response
TUESDAY, Oct. 26 (HealthDay News) -- Hormone level variation during a woman's menstrual cycle may affect her response to emotional stimuli, according to a study presented at the annual meeting of the American Society for Reproductive Medicine, held from Oct. 23 to 27 in Denver.
ASRM: Relationship Between Obesity and Infertility Explored
TUESDAY, Oct. 26 (HealthDay News) -- Obesity appears to be associated with increased assisted reproductive technology cycle cancellation and treatment and pregnancy failures, and also with oocyte immaturity in women undergoing in vitro fertilization, according to two studies presented at the annual meeting of the American Society for Reproductive Medicine, held from Oct. 23 to 27 in Denver.
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