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Fertility Treatments Aren't Significantly Linked to Birth Defects
October 22, 2014

 

WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- The risk of birth defects is low among children conceived using assisted reproductive technologies (ART), according to a new study.

Researchers examined more than 300,000 births in Massachusetts between 2004 and 2008. Of those babies, 11,000 were conceived using ART.

Assisted reproductive technologies include fertility treatments where both eggs and sperm are handled, such as in-vitro fertilization, according to the U.S. Centers for Disease Control and Prevention.

Techniques where just sperm are handled, such as artificial insemination, are not considered assisted reproductive technology, according to the CDC.

The ART-conceived children had slightly higher rates of cardiac and non-cardiac birth defects than children who were conceived naturally. But, overall rates of birth defects among ART-conceived children were low, the researchers said.

Rates of cardiac birth defects were 0.82 percent among ART-conceived children and 0.52 percent among naturally conceived children, the study showed. Rates of non-cardiac birth defects were 1.8 percent and 1.5 percent, respectively, according to the researchers.

The study was presented Tuesday at the annual meeting of the American Society for Reproductive Medicine in Honolulu. Findings from meetings are generally considered preliminary until they're published in a peer-reviewed journal.

"While we need to better understand any relationship between birth defects and infertility, it is comforting to confirm that rates of birth defects remain low among those children conceived using assisted reproductive technologies," Dr. Charles Coddington, president of the Society for Assisted Reproductive Technology, said in a society news release.

More information

The U.S. Centers for Disease Control and Prevention outlines how to reduce the risk of birth defects.

Copyright © 2014 HealthDay. All rights reserved.


SOURCE: American Society for Reproductive Medicine, news release, Oct. 20, 2014...

Experimental Infertility Treatment Seems Effective, Cheaper
October 22, 2014

 

TUESDAY, Oct. 21, 2014 (HealthDay News) -- A crucial part of conventional in vitro fertilization (IVF) -- the incubation of embryos in a laboratory dish -- can instead take place in a device inside the vagina, new research suggests.

Scientists from the United States and Colombia contend that the device, called an INVOcell, might sharply cut costs for pricey IVF procedures among certain women. It could also make the technology more accessible to those who don't live near big-city assisted reproduction centers, the researchers said.

In a small U.S. study, pregnancy rates were nearly identical between women whose eggs were conventionally incubated with sperm in the lab for five days and those whose eggs and sperm were placed in the INVOcell device for the same amount of time.

Once thought of as producing "test tube babies," IVF is one of the most prominent forms of assisted reproduction and has been used in the United States since 1981. About 65,000 babies were born in the United States in 2012 through 176,000 assisted reproduction cycles, typically costing upwards of $10,000 apiece, according to the U.S. Centers for Disease Control and Prevention.

"One reason assisted reproduction is limited is because of cost, and part of that is the incubation systems we use ... which are complex devices that require calibration and daily quality control checks," said study author Dr. Kevin Doody, founder of the Center for Assisted Reproduction in Bedford, Texas.

"We think we've been able to simplify the IVF process to require minimal monitoring with a high pregnancy rate," Doody added.

The research is scheduled for presentation Wednesday at the American Society for Reproductive Medicine meeting in Honolulu. Studies presented at scientific conferences typically have not been peer-reviewed or published, and results are considered preliminary.

Optimal candidates for the INVOcell technique are infertile women able to produce many viable eggs using ovulation-stimulating hormones, experts said.

Manufactured by INVO Bioscience of Medford, Mass., the small, cylindrical device can be held in place in the vagina with a diaphragm, where the vaginal environment is expected to maintain the right temperature, pH and other conditions necessary for fertilization and early embryo development. After three to five days, the device is removed and embryos can be recovered and transferred to the uterus.

Doody's study divided 33 infertile women between ages 18 and 38 into two groups. After egg retrieval, each patient's eggs were incubated in a petri dish with sperm for two to four hours, after which up to 10 eggs per patient were either placed in the INVOcell device or moved to the next stage of conventional lab incubation.

Embryos resulting from both methods were of comparable quality, and similar pregnancy rates resulted: 10 of 17 women from the INVOcell group and 10 of 16 from the incubator culture group reported ongoing pregnancies.

"My impression is wow, this is really interesting stuff," said Dr. Timothy Hickman, chief of reproductive endocrinology at Houston Methodist Hospital in Texas. "IVF tends to be a highly complex process ... and here's a novel way to try to provide something for a certain population that can benefit. This is never going to replace an IVF lab, but maybe for a certain population it may work out right."

A second study on the INVOcell device presented at the reproductive medicine meeting indicated that the technique is also effective when eggs need to be manually injected with sperm to achieve fertilization, a procedure called intracytoplasmic sperm injection.

Dr. Elkin Lucena, scientific director and founder of Colombian Fertility and Sterility Center in Bogota, led research on couples who underwent 172 cycles of IVF in which their embryos were incubated in the INVOcell device for three days, with an average of two embryos transferred into the uterus afterward. Pregnancy resulted in 40 percent of embryo transfers -- roughly the same rate as conventional IVF.

"Especially from a psychological impact, couples feel they're participating in conception too and carrying their own [offspring] inside of them instead of in a lab," Lucena said. "And the cost is lowered a lot, which is making it easier for people to access these techniques."

The INVOcell vaginal device, currently under review by the U.S. Food and Drug Administration, is already approved for use in Canada and several other countries.

Doody, who said he owns about $10,000 of publicly traded stock in INVO Bioscience, said he thinks using the device could halve the cost of a typical cycle of IVF treatment.

"My guess is that at least two-thirds of IVF patients could be treated with this type of [technique]," Doody said.

One difference between the conventional treatment and the INVOcell approach is that eggs and sperm are placed together in the intravaginal device before knowing if fertilization has occurred.

"That is a waiting game for the patient," said Doody. "But in all the cycles we've done, we've not had any cases where we didn't have embryos [created] to transfer back to the uterus," he added.

More information

The U.S. National Library of Medicine has more about IVF.


SOURCES: Kevin Doody, M.D., founder, Center for Assisted Reproduction, Bedford, Texas; Elkin Lucena, M.D., scientific director and founder, Colombian Fertility and Sterility Center, Bogota, Colombia; Timothy Hickman, M.D., chief, reproductive endocrinolog...

Black Women Fare Worse With Fertility Treatments, Study Says
October 21, 2014

 

TUESDAY, Oct. 21, 2014 (HealthDay News) -- Black women undergoing in vitro fertilization (IVF) are only about half as likely as white women to become pregnant using the popular assisted reproduction technique, new research indicates, and the racial disparity persists even when donor eggs are used.

In the study, about 31 percent of white patients became pregnant after IVF, compared to about 17 percent of black patients.

Analyzing more than 4,000 IVF cycles over two years to tease out the impact of race, scientists from University of Chicago also found that miscarriage after IVF -- where eggs and sperm are joined in a lab and implanted in the woman's uterus -- occurred twice as often among blacks than whites.

These racial differences remained even though the researchers controlled for factors affecting pregnancy such as age, body-mass index (BMI, a measurement of weight vs. height), hormone levels and smoking. Asian women also experienced somewhat lower live birth rates than whites after IVF, but rates among Hispanic women were comparable to whites.

"We were just struck by these outcomes," said study author Dr. Eve Feinberg, an assistant clinical professor at University of Chicago Medical Center and a physician at Fertility Centers of Illinois. "They had been reported previously in other studies, but our study, which is quite large, really confirmed those other findings."

The study was presented Monday at the American Society for Reproductive Medicine (ASRM) annual meeting in Honolulu. Research presented at scientific meetings typically has not been published or peer-reviewed and results are considered preliminary.

Used in the United States since 1981, IVF is one of the most common forms of assisted reproduction. About 65,000 babies were born in the United States in 2012 through 176,000 assisted reproduction cycles, typically costing upwards of $10,000 apiece, according to the U.S. Centers for Disease Control and Prevention.

In another study being presented at the ASRM meeting, researchers from Columbia University Medical Center in New York found that racial differences for IVF success persisted between white and black women even when donor eggs were used.

In that research, led by Dr. Lisa Carey Grossman, uterine conditions such as fibroids or prior cesarean surgery were taken into account. Because black women have higher incidences of such conditions, the scientists compared black and white egg donor recipients who had similar uterine histories.

Despite that, black women still experienced significantly lower embryo implantation rates than whites -- 30.4 percent compared to 36.3 percent, Grossman said.

Dr. Edward Illions, a reproductive endocrinologist at Montefiore Medical Center in Hartsdale, N.Y., who wasn't involved in the new research, said he has observed the same racial disparities in IVF outcomes in his own practice.

"I'm not actually surprised, because the [medical] literature before this almost uniformly has shown a lower success rate in African-American women compared to Caucasians," said Illions, also an associate professor of clinical obstetrics, gynecology and women's health at Montefiore Institute for Reproductive Medicine.

"In most of the studies also, the BMIs of African-American women have been dramatically higher," he added. "We know from lots of data that women with higher BMIs have worse IVF outcomes, even with donor eggs."

Illions said scientists aren't yet sure why higher BMI is linked to lower IVF success. "It has to do with uterine receptivity," he said, but he added that the exact cause hasn't been pinpointed.

The experts agreed that more large-scale research is needed to determine why racial disparities in IVF outcomes persist.

More information

There's more on IVF at the U.S. National Library of Medicine.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Eve Feinberg, M.D., assistant clinical professor, University of Chicago Medical Center, and physician, Fertility Centers of Illinois, Chicago; Lisa Carey Grossman, M.D., obstetrician-gynecologist, Columbia University Medical Center, New York...

For Infertility Treatment, Should He Drink Less Coffee, More Booze?
October 20, 2014

 

MONDAY, Oct. 20, 2014 (HealthDay News) -- A man's love of coffee could hamper the success of a couple's infertility treatment, a small new study suggests.

But mild alcohol use by would-be fathers might help boost the odds of pregnancy through in vitro fertilization, the findings indicate.

The Boston researchers aren't ready to encourage men enrolled in IVF to cut coffee consumption and have an extra beer with dinner. Still, these preliminary results were "definitely surprising," said study co-author Dr. Jorge Chavarro, an assistant professor of nutrition and epidemiology at Harvard School of Public Health in Boston.

"We'd like to follow up and see if it replicates in other populations, such as other couples who are trying to conceive naturally," he said.

The research is to be presented Monday at the American Society for Reproductive Medicine annual meeting in Honolulu.

Previous research into male fertility hasn't found connections between alcohol or caffeine and scientific measurements of semen quality. But Chavarro said those measurements might not reflect other aspects of male fertility that are crucial to a man's ability to impregnate a woman, he said.

Enter the new study, which looks beyond measurements of sperm quality to evaluate the effect of male beverage consumption on IVF birth rates.

The researchers focused on 105 men, average age 37, involved in 214 IVF treatments between 2007 and 2013. All answered questions about their diet before undergoing treatment.

Overall, more than half of the couples achieved a pregnancy in each IVF cycle, the researchers found. Couples in which the man consumed the most caffeine (equivalent to three or more 8-ounce cups of coffee a day) were half as likely to have a pregnancy as couples where the male consumed the least caffeine (less than a cup of coffee daily), the researchers said.

Ultimately, after adjusting their statistics for factors such as age or obesity, the researchers said live births were least likely -- just 19 percent of the time -- in the couples whose male partners consumed the most caffeine.

But the live pregnancy rate was 52 percent to 60 percent for couples where the men consumed the least caffeine, said study author Dr. Anatte Karmon, a research fellow of reproductive endocrinology and infertility at Massachusetts General Hospital.

The numbers for alcohol consumption only bordered on statistical significance, Karmon said. While 28 percent of couples in which the men drank the least alcohol had live births, she said, live births occurred for 57 percent of couples where the man drank the most -- 22 grams or more per day, which is less than the 28 grams found in two "standard" drinks or two 12-ounce beers.

Chavarro said researchers don't know why caffeine or alcohol might have these effects. One possibility is that they're making men more or less likely to have sex with their partners. But Chavarro said that a change in sexual routine probably wouldn't have had much effect on pregnancy since the couples had infertility problems.

Dr. Rebecca Sokol, a professor of medicine, obstetrics and gynecology at Keck School of Medicine at University of Southern California, questioned the study's conclusions. The researchers only looked at a small number of men and the study doesn't prove whether alcohol or caffeine actually affect fertility, she said.

Other research suggests that alcohol could be toxic to sperm, said Sokol, who is also president of the American Society for Reproductive Medicine.

What should couples do with the information from the study? Nothing right now, Chavarro said. "As far as we are aware, this is the first time this has been reported," he said. "There needs to be a lot more replication before anyone can make a strong recommendation to patients."

However, "we know from other studies that alcohol at very high intakes is not a good idea" for men in infertile couples, he said. "The alcohol levels in this study are very modest."

Sokol also advised moderation. "It is in the best interest of couples who are trying to initiate a pregnancy that they moderate their use of drugs and chemicals because all could potentially impact fertility," she said.

Chavarro is co-author of another new study being presented at the fertility meeting that suggests -- but doesn't prove -- that eating fruits and vegetables containing residue from pesticides could harm sperm quality. The study doesn't say if organic food would be a better alternative, however.

Another new study, written by researchers at Sao Paulo Federal University in Brazil and scheduled to be presented Tuesday at the conference, finds that smoking can impair fertility. Smoking contributes to problems with semen quality in men with a condition known as varicocele -- enlarged veins in the scrotum -- the researchers said.

All three studies should be considered preliminary since they have not undergone the peer review process required of research published in major medical journals.

More information

For more about infertility, see the U.S. Centers for Disease Control and Prevention.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Jorge Chavarro, M.D., Ph.D., assistant professor, nutrition and epidemiology, Harvard School of Public Health, Boston; Anatte Karmon, M.D., clinical and research fellow, reproductive endocrinology and infertility, Massachusetts General Hospital, ...

As U.S. Economy Worsened, Vasectomy Rates Rose, Study Finds
October 20, 2014

 

MONDAY, Oct. 20, 2014 (HealthDay News) -- During the recent "Great Recession," worries about the cost of raising children in an uncertain job market may have spurred an uptick in vasectomies, a new study suggests.

"Despite an unchanged desire for more children, men in relationships reported planning for smaller families," said a team led by Dr. Bobby Najari, a urologist at Weill Cornell Medical College in New York City.

Najari and colleagues reported the findings Monday in Honolulu at the annual meeting of the American Society for Reproductive Medicine (ASRM).

In a vasectomy, the sperm-transport system is interrupted by blocking the structure known as the vas deferens, which carries sperm from the testicle to the urethra. If a man changes his mind about wanting children, a reversal often can be done.

Prior studies have pointed to a trend of rising vasectomy rates as the economy declined. Speaking to HealthDay in March of 2009, Dr. Marc Goldstein -- a co-author on the new study who is also at Weill Cornell -- said that his office had noticed an upsurge in vasectomy requests.

"I used to do one to two every Friday. Now I'm doing three on Fridays. There's been a significant increase," Goldstein said.

"Nobody came in and said they were having a vasectomy because the [stock] market crashed," Goldstein added. "Most are saying, 'We've been thinking about it for a long time,' and [the crash] influenced their decision. They're saying with the cost of private school for three kids, they can't afford to have another one."

Another study, this one published at last year's ASRM meeting, found a similar trend. That research, led by Dr. Anand Shridharani of Erlanger Health System in Chattanooga, Tenn., looked at data from men having vasectomies at a facility at the Medical College of Wisconsin.

Again, the study found that "as the median income for Wisconsin declined, the rate of vasectomies annually went up," Shridharani said.

The new study is different because it relied not on data from a particular medical center, but on countrywide data from the National Survey for Family Growth.

In the study, Najari and Goldstein, along with co-author Dr. Peter Schlegel, looked at data on almost 9,000 adult men. The data covered the time of the recession (as defined by the National Bureau of Economic Research), from December 2007 through June 2009.

According to the researchers, the survey found "no change in the proportion of men who wanted more children," which stayed steady at about 68 percent.

However, that desire was perhaps tempered by economic realities, because "men interviewed after the recession [began] planned on having fewer children," the study found.

Overall, the recession appeared to be tied to a 28 percent rise in the odds that a man would undergo vasectomy, the Cornell team said. Vasectomy rates rose from 3.9 percent of men interviewed before the recession to 4.4 percent after the economic downturn.

At the same time, the percentage of men who had full-time work and/or medical insurance declined, the researchers pointed out.

Of course, while the study can point to an association between poorer economic times and a rise in vasectomy rates, it cannot prove a cause-and-effect relationship. In addition, findings reported at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

Still, the researchers believe the study supports the notion that "interest in vasectomy may vary based on economic factors, given the financial impact of child rearing."

More information

Find out more about vasectomy at the American Urological Association.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Oct. 20, 2014, presentation, American Society for Reproductive Medicine annual meeting, Honolulu...

Bro Alert: Too Much Booze May Harm Your Sperm
October 03, 2014

 

THURSDAY, Oct. 2, 2014 (HealthDay News) -- The more alcohol young men drink, the lower their sperm count and quality may be, new research suggests.

"Many studies have shown that excessive alcohol intake is bad for general health, but few have shown impacts on reproductive health, except at very high levels," said Dr. Michael Eisenberg, an assistant professor of urology at Stanford University School of Medicine who was not involved with the study. "This provides another lifestyle factor that men could be counseled about when trying to conceive."

Although the men drinking the most alcohol each week -- 40 units or more -- had the lowest sperm counts, the most surprising finding was that an effect was seen even in men drinking as little as five units a week, said lead researcher Dr. Tina Kold Jensen, a professor of environmental medicine at the University of Southern Denmark. A unit was defined as a single beer, a glass of wine or about the equivalent of a shot glass of liquor.

However, because of the study's design, the research couldn't show that alcohol was the cause of sperm changes, only that higher levels of drinking were associated with fewer and less quality sperm. The researchers said they did try to take other possible causes into account, however.

"We tried to adjust for other possible factors like diet, smoking, weight, etc., which did not explain the association. But we cannot rule out whether this effect may be due to other factors [not measured] associated with alcohol intake," Jensen said.

The research involved more than 1,200 Danish men undergoing a required medical examination to determine whether they were fit for military service. The men were between the ages of 18 and 28. They filled out questionnaires about their drinking, provided a semen sample and had their blood drawn.

Sperm concentration, total sperm count and percentage of normal sperm were all poorer among men having at least five drinks a week, compared to those drinking just one drink weekly. The amount of testosterone measured in the men's blood, however, increased as their alcohol intake increased.

The drop in sperm count and quality became particularly significant among men downing at least 25 drinks a week. Those drinking 40 or more drinks a week had a 33 percent lower sperm concentration than those consuming one to five drinks a week.

Binge drinking -- having five or more drinks in a two-hour period -- did not appear to influence the men's sperm. One possible reason for this finding was that it was difficult to distinguish between binging and men's typical weekly alcohol consumption because "most young men who binged also had a high alcohol intake," the researchers noted.

"Many men are quiet drinkers who don't realize that this may affect them as they drink a lot more than they admit to," said Dr. Michael Heard, an obstetrician, gynecologist and reproductive endocrinologist at The Heard Clinic and Houston Methodist Hospital in Houston.

According to Heard, being intoxicated can lead to changes in hormones and other chemicals in the body, including cortisol, glucose, insulin and male hormones. "All of these would affect sperm quality," he said. And, poor sperm quality can affect fertility, he added.

The study was published in the Oct. 2 issue of the journal BMJ Open.

A second study found that drinking a lot of alcohol was linked to a higher risk of contracting human papillomavirus (HPV), a sexually transmitted disease. This study was published in the Oct. 2 issue of the journal Sexually Transmitted Infections.

HPV can cause head and neck cancers and penile and anal cancers in men, according to the U.S. National Cancer Institute (NCI). A vaccine available to men under age 27 protects against two of the cancer-causing strains of HPV, according to the NCI.

The second study included more than 1,300 American men. The researchers found that those who drank the most alcohol (more than 10 grams a day) were 13 percent more likely to have any HPV type and 35 percent more likely to have a cancer-related HPV type, compared to those drinking the least amount of alcohol (less than 0.1 gram per day). The U.S. National Institute on Alcohol Abuse and Alcoholism defines a standard drink as one containing 14 grams of alcohol.

Even after the researchers took into account the number of sex partners the men had and whether they smoked -- another risk factor for HPV-associated cancers -- the study still found an link between alcohol consumption and HPV infection.

Past research has found that moderate alcohol consumption can reduce the body's ability to defend against viral infections, the study noted. However, as with the first study, this research was only able to find an association; it wasn't designed to prove that alcohol definitively caused the increased risk.

"Alcohol may have an effect on the immune system, which may increase the risk of HPV," Heard said, though he expressed doubt about the accuracy of the men's reported sexual activity and number of partners.

All three experts said, however, that these findings all point to the importance of limiting alcohol intake among young men.

"Given the known health impacts of excessive drinking, these new studies provide newer risk factors for higher alcohol consumption," Eisenberg said. "Thus, moderation is probably best."

More information

Learn more about male fertility from the American Society for Reproductive Medicine.


SOURCES: Michael Eisenberg, M.D., director, male reproductive medicine and surgery, and assistant professor, department of urology, Stanford University School of Medicine, Stanford, Calif.; Tina Kold Jensen, M.D., Ph.D., professor, department of environme...

Free, Long-Acting Contraceptives May Greatly Reduce Teen Pregnancy Rate
October 01, 2014

 

WEDNESDAY, Oct. 1, 2014 (HealthDay News) -- Giving teenage girls free birth control -- especially long-acting implanted devices -- could slash pregnancy and abortion rates to well below the current U.S. average, new findings suggest.

In a study of 1,400 teenage girls, researchers found that counseling and free contraceptives substantially cut the girls' rates of unplanned pregnancy and abortion. Over three years, their annual pregnancy rate averaged 34 per 1,000 girls -- versus a rate of 158 per 1,000 among all sexually active teenage girls in the United States.

Meanwhile, the abortion rate was 9.7 per 1,000 girls in the study, compared to a national abortion rate of 41.5 per 1,000 sexually active girls, the researchers report in the Oct. 2 issue of the New England Journal of Medicine.

"What we're seeing here are extraordinary declines," said Bill Albert, chief program officer for the Washington, D.C.-based National Campaign to Prevent Teen and Unplanned Pregnancy.

Albert, who was not involved in the research, pointed to a key element of the study: Girls received counseling that emphasized the safety and effectiveness of intrauterine devices (IUDs) and contraceptive implants -- and most of the teens opted for those types of birth control.

IUDs and implants are substantially more effective than the Pill or condoms, which are currently the top birth control choices among U.S. teens, according to the American Academy of Pediatrics (AAP).

The "magic" of IUDs and implants, according to Albert, is that they are put in place and then last for years -- or until a woman decides to remove them. "These types of birth control are 'set it and forget it,'" Albert said. "They don't rely on perfect use."

And from the standpoint of preventing unplanned pregnancies, the devices "have the potential to be game-changing," Albert said.

The new report comes on the heels of new recommendations from the AAP, advocating IUDs and implants as the first-choice contraceptives for teenagers.

Gina Secura, the lead researcher on the new study, welcomed the AAP guidelines, which came out this week.

"For so long we've dismissed these types of contraceptives for teenagers, thinking girls won't want them or will find them too complicated," said Secura, a researcher at Washington University School of Medicine in St. Louis.

But, she said, her team's findings show that teenagers are willing to use IUDs and implants. Even more importantly, she added, the benefits are clear.

According to Planned Parenthood, IUDs are implanted in the uterus, where they release small amounts of either copper or the hormone progestin. The contraceptive implant, about the size of a matchstick, is inserted under the skin of the arm, where it releases controlled amounts of progestin.

The hormonal IUD (sold under the brand name Mirena) can prevent pregnancy for five years, while the copper version (ParaGard) works for about 10 years. The contraceptive implant (Implanon, Nexplanon) lasts for three years, according to Planned Parenthood.

According to the U.S. Centers for Disease Control and Prevention (CDC), between 0.2 percent and 0.8 percent of women who use an IUD will have an unplanned pregnancy within a year. That rate is just 0.05 percent with an implant.

In contrast, about 9 percent of women on the Pill have an unintended pregnancy each year. Condoms, as people typically use them, are even less effective -- with a pregnancy rate of 18 percent to 21 percent, according to the CDC.

Still, only about 5 percent of U.S. teens currently use IUDs or implants, according to background information in the study. Secura said that going into this study, her team thought price was the major obstacle: IUDs cost $500 to $1,000 upfront, while contraceptive implants range from $400 to $800.

But the researchers quickly found out that many young women simply don't know much about the devices.

Albert said that to translate these study findings to the real world, doctors and other providers are going to have to get up-to-date with the evidence for IUDs and implants -- and either become comfortable with offering the devices, or be able to refer girls to a provider who is.

Planned Parenthood welcomed the new findings.

"This study shows that the IUD and implant help reduce teen pregnancy," said Dr. Vanessa Cullins, vice president of external medical affairs for Planned Parenthood Federation of America. "IUDs and implants are safe for most women, including adolescents and women who have not yet children, and they are an especially good option for young women who want to delay starting their families for a few years, so they can be the best parents they can be."

As for cost, under the Affordable Care Act, many insurers have begun covering prescription birth control methods without copays.

"Hopefully," Albert said, "the cost of IUDs and implants will become less of a concern."

Still, Secura said, teens can face an extra obstacle: wanting to keep their contraception choice private. State laws on minors' access to contraception vary. But even when teens can get it on their own, their parents will probably find out when they receive their insurer's explanation of benefits, Secura pointed out.

Albert said that ideally, kids should feel they can talk to their parents. "Parents and kids should have discussions about relationships, sex and contraception -- early and often," he said.

He added that, despite some parents' worries, those talks do not end up encouraging kids to have sex. "Research shows that's a myth," Albert said. "When parents discuss these issues, their kids tend to delay sex. And when they do have sex, they're more likely to use contraception."

More information

The U.S. Department of Health and Human Service has more on birth control methods.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Gina Secura, Ph.D., M.P.H., senior scientist, obstetrics and gynecology, Washington University School of Medicine, St. Louis, Mo.; Bill Albert, program director, National Campaign to Prevent Teen and Unplanned Pregnancy, Washington, D.C.; Oct. 2,...

Pediatricians Endorse IUDs, Implants for Teen Birth Control
September 29, 2014

 

MONDAY, Sept. 29, 2014 (HealthDay News) -- Long-acting contraceptive devices should be the first choice of birth control for teenage girls, new recommendations from the American Academy of Pediatrics state.

Although most U.S. teens opt for condoms or birth control pills, two other forms of contraception -- intrauterine devices (IUDs) and contraceptive implants -- are much more reliable, according to the academy.

And they should be the "first-line" choices for teenage girls who don't want to remain abstinent, the academy says in guidelines published Sept. 29 in the journal Pediatrics.

The advice is in line with guidelines from other medical societies, such as the American College of Obstetricians and Gynecologists.

But experts said they hope the official recommendation to pediatricians will increase teenage girls' use of IUDs and implants.

The academy's move is "fantastic," said Dr. David Eisenberg, an assistant professor of obstetrics and gynecology at Washington University in St. Louis.

"I'm happy to see that every major medical or public health organization in the United States agree that IUDs and implants should be the 'default' first-line contraceptive methods for all women and girls who want them," said Eisenberg, who was not involved in writing the guidelines.

According to Planned Parenthood, IUDs are implanted in the uterus, where they release small amounts of either copper or the hormone progestin. The contraceptive implant, about the size of a matchstick, is inserted under the skin of the arm, where it releases controlled amounts of progestin.

The hormonal IUD (sold under the brand name Mirena) can prevent pregnancy for five years, while the copper version (ParaGard) is effective for about 10 years, according to Planned Parenthood. The contraceptive implant (Implanon, Nexplanon) works for up to three years.

The contraceptives are sometimes called "set and forget" birth control, noted Megan Kavanaugh, a researcher at the Guttmacher Institute in New York City -- a nonprofit organization that focuses on reproductive health.

For condoms and birth control pills to be most effective, people have to use them perfectly. Not so with IUDs and implants, Kavanaugh pointed out.

"That's important for adults, too," she said. "But teenagers are notorious for having a lot on their plates, and being forgetful."

According to the U.S. Centers for Disease Control and Prevention, between 0.2 percent and 0.8 percent of women who use an IUD will have an unplanned pregnancy within a year. The rate is just 0.05 percent with a contraceptive implant.

With the Pill, about 9 percent of women have an unintended pregnancy each year. Condoms, as people typically use them, are less effective -- with an unplanned pregnancy rate between 18 percent and 21 percent, according to the CDC.

Despite that, U.S. women and teens opt for condoms and birth control pills much more often than IUDs or implants. Part of the reason may be that young women don't realize the devices are an option for them, Kavanaugh said.

She pointed to the marketing for Mirena, for instance, which targets "busy moms," even though medical experts consider it an option for most women.

When IUDs came out years ago, there were concerns they might raise the risk of pelvic infection and jeopardize a woman's future fertility, according to background information in the guidelines. But IUDs currently on the market do not carry those risks.

"We now have over a decade of data showing that [IUDs and implants] are safe for adolescents," said Dr. Mary Ott, one of the authors of the new recommendations and an associate professor of pediatrics at Indiana University School of Medicine.

Ott noted that the U.S. teen pregnancy rate has been declining since it peaked in the 1990s. And long-acting contraceptives are a "great tool" to further that trend, she said.

But boosting women's awareness is just one step, according to Eisenberg. He said "poorly informed health care providers" present another barrier; a 2012 study by the CDC found that 30 percent of doctors and other providers doubted the safety of IUDs for women who've never given birth.

Ott agreed that young women still face obstacles to getting IUDs and implants -- cost being one of them.

According to Planned Parenthood, IUDs cost $500 to $1,000, while contraceptive implants range from $400 to $800. Still, Ott noted that many insurers are now footing the bill for the contraceptives.

As far as parental consent, U.S. states have different laws, according to the academy. But family planning clinics funded by the federal Title X are required to provide confidential services to minors.

More information

The U.S. Department of Health and Human Service has more on birth control methods.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Mary Ott, M.D., associate professor, pediatrics, Indiana University School of Medicine, Indianapolis; David Eisenberg, M.D., M.P.H., assistant professor, obstetrics and gynecology, Washington University in St. Louis School of Medicine; Megan Kava...

Failed Infertility Treatment Linked to Worse Mental Health in Study
September 10, 2014

 

WEDNESDAY, Sept. 10, 2014 (HealthDay News) -- Women who continue to long for a baby years after infertility treatments fail have worse mental health than women who are able to let go of that desire, according to a large new European study.

Although the researchers noted that other factors, aside from failed treatments, could play a role in the women's mental health, they concluded that all women who undergo treatment for infertility should also receive psychological support.

"This would enable fertility staff to identify patients more likely to have difficulties adjusting to the long term, by assessing the women's possibilities to come to terms with their unfulfilled child-wish," the study's lead author, Dr. Sofia Gameiro, a lecturer at the School of Psychology at Cardiff University in Wales, said in a news release. "These patients could be advised to seek additional support from mental health professionals and patient support networks."

The study, published Sept. 9 in the journal Human Reproduction, involved 7,148 women who underwent fertility treatment at one of 12 IVF hospitals in The Netherlands.

The researchers examined surveys completed by the women more than a decade after their fertility treatment. The surveys included questions about their age, education, marital status, menopause, type of infertility treatment and whether the infertility troubles were due to their own health issues or their partner's.

In a separate mental health questionnaire, the women described how they felt in the past four weeks. The women were also asked if they had biological or adopted children and whether they still wanted children.

Although most of the women whose fertility treatments were not successful accepted the fact, 6 percent still wished they had children. This prolonged longing for children was linked to worse mental health regardless of the health issues the women faced or the type of treatment they received, according to the study.

"We found that women who still wished to have children were up to 2.8 times more likely to develop clinically significant mental health problems than women who did not sustain a child-wish," said Gameiro. "The strength of this association varied according to whether women had children or not.

Thee results showed that women had better mental health when their partner was the cause of their infertility or if the cause was unknown. Women who began infertility treatment later in life and were married or living with a partner also fared better than women who started treatment at a younger age and were single, divorced or widowed. Those with more education also had better mental health, the study authors said.

"Our study improves our understanding of why childless people have poorer adjustment. It shows that it is more strongly associated with their inability to let go of their desire to have children," Gameiro said. "It is quite striking to see that women who do have children but still wish for more children report poorer mental health than those who have no children but have come to accept it."

Gameiro said it isn't known why some women may find it more difficult to let go of their child-wish than others. She speculated that it might be "easier to let go of a child-wish if women find other things in life that are fulfilling, like a career," she said.

The study uncovered an association between failed fertility treatment and mental health. It did not prove cause-and-effect.

More information

The American Psychological Association information on psychological challenges associated with infertility.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Cardiff University, news release, Sept. 10, 2014...

Study Questions Link Between Antidepressants, Miscarriage
September 09, 2014

 

TUESDAY, Sept. 9, 2014 (HealthDay News) -- Some studies have found that women who use common antidepressants early in pregnancy face a raised risk of miscarriage, but new research suggests the link might be better explained by the depression, rather than the drugs that treat it.

Looking at records for more than 1.2 million pregnant women, researchers found that those prescribed selective serotonin reuptake inhibitors (SSRIs) in their first trimester were 27 percent more likely to have a miscarriage than women who weren't on the drugs.

But a similar increase was also found among women who'd stopped using an SSRI three months to a year before becoming pregnant.

That suggests some other factor -- possibly the depression itself -- might explain the miscarriage link, the researchers suggested.

"We believe that these results clearly indicate that miscarriage is not associated with SSRIs, but with conditions associated with the use of SSRIs," said lead researcher Dr. Jon Andersen, of Copenhagen University Hospital in Denmark.

Not everyone was convinced, though.

Dr. Adam Urato, a maternal-fetal medicine specialist at Tufts Medical Center in Boston, has studied the issue. He said the new research has limitations, including its reliance on prescription records because it's impossible to know whether women actually took their medications.

"This kind of misclassification will bias the results toward the null, which just means that it makes the study more likely to say that the drugs are safe when they aren't," Urato said.

More important, Urato said, the findings should be seen in the wider context. A number of studies have linked SSRIs during pregnancy to a heightened risk of miscarriage, preterm birth, pregnancy complications such as pre-eclampsia, and developmental disorders such as autism later in a child's life.

Those types of studies do not prove cause-and-effect. But Urato said there's some biological evidence to back up a link: Animal research has shown that SSRI exposure during pregnancy can cause the same types of problems that have turned up in some human studies.

Plus, "we know that the serotonin system is crucial for the developing fetus. And SSRIs disrupt that system," Urato said.

Serotonin is a chemical "messenger" that helps regulate mood, appetite, blood vessel dilation and other vital functions. SSRIs, which raise serotonin levels, have become the "first-line" drug against depression, and include drugs such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and paroxetine (Paxil).

Andersen said one of the difficulties in studying whether SSRIs contribute to miscarriage is that it's hard to know whether any negative effect is the result of the drugs, the underlying depression, or some other factor.

He added he believes that his study helps address that problem by including women who were recently on SSRIs, but stopped before becoming pregnant.

The findings, reported in the October issue of Obstetrics & Gynecology, are based on records for more than 1.2 million Danish women who were pregnant between 1997 and 2010.

Of nearly 23,000 women who had a prescription for an SSRI in the first 35 days of pregnancy, 12.6 percent had a miscarriage. That compared with just over 11 percent of women with no SSRI prescription.

When Andersen's team considered factors such as maternal age and income, SSRI use was still tied to a 27 percent increase in miscarriage risk. But there was a similar increase among women who'd stopped an SSRI prescription at least three months before pregnancy.

Andersen pointed to possible explanations for the miscarriage risks. "Other studies have shown that people suffering from depression are more likely to abuse alcohol and smoke," he said, "and it is possible that women [with] depression are less likely to follow the recommendation of folic acid supplementation before and during pregnancy."

The researchers' conclusions are "reasonable," said Christina Chambers, director of the Center for the Promotion of Maternal Health and Infant Development at the University of California, San Diego.

And while other studies have tied SSRIs to pregnancy risks, those excess risks have been "modest," Chambers noted.

"If there are risks, they seem to be fairly small," she said.

So for any one woman, those potential risks would have to be weighed against the risks of stopping an SSRI, particularly for women with more severe depression, Chambers said.

Urato agreed that for some women, taking an SSRI during pregnancy might be the right move. "Am I saying no one should take these drugs? No," he said.

But, Urato added, women should be told what the evidence is, so they can make an informed decision about whether to stick with their medication.

More information

The Organization of Teratology Information Specialists has more on medication safety during pregnancy.

Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Jon Troerup Andersen, M.D., Ph.D., Copenhagen University Hospital, Copenhagen, Denmark; Christina Chambers, Ph.D., M.P.H., director, Center for the Promotion of Maternal Health and Infant Development, University of California, San Diego; Adam Ura...

Consumer Reports Advises Pregnant Women to Avoid Tuna
August 21, 2014

 

THURSDAY, Aug. 21, 2014 (HealthDay News) -- In a new review of seafood safety, Consumer Reports is advising that pregnant women avoid eating tuna due to concerns about mercury exposure.

"We're particularly concerned about canned tuna, which is second only to shrimp as the most commonly eaten seafood in the United States. We encourage pregnant women to avoid all tuna," Jean Halloran, director of food policy initiatives for Consumers Union, the advocacy division of Consumer Reports, said in a news release from the group.

While pregnant women and children are at greatest risk from mercury in seafood, anyone can be at risk if they eat too much seafood with high mercury levels, Consumer Reports noted.

Adults who eat 24 ounces (1.5 pounds) or more of seafood per week should also avoid seafood with high mercury levels, including sushi made with tuna, the independent product testing group said.

On the other hand, there are nearly 20 types of seafood that people -- even pregnant women and children -- can eat several times a week without worrying about mercury exposure, according to Consumer Reports.

While fish and other seafood contain healthy omega-3 fatty acids and other nutrients, many people are concerned that these foods contain high levels of mercury, which can damage the brain and nervous system.

In its review, Consumer Reports analyzed U.S. Food and Drug Administration data on mercury levels in various types of seafood. The group identified about 20 types of seafood that can be consumed several times a week without raising concerns about mercury exposure.

Seafood with the lowest mercury levels include wild salmon, scallops, shrimp (most wild and U.S. farmed) and tilapia. Other seafood with low-mercury levels include catfish, crab, trout, flounder and sole (flatfish), according to the report that appears in the October issue of Consumer Reports magazine.

Newly updated guidelines from the FDA and Environmental Protection Agency say that women of childbearing age and young children should not eat the four types of fish with the highest mercury levels: swordfish, shark, king mackerel and tilefish from the Gulf of Mexico. The agencies are also considering adding marlin and orange roughy to that list, according to Consumer Reports.

More information

The U.S. Environmental Protection Agency has more about mercury in seafood.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Consumer Reports, news release, Aug. 21, 2014...

White Women More Likely to Seek Fertility Treatment: Report
August 20, 2014

 

WEDNESDAY, Aug. 20, 2014 (HealthDay News) -- White, straight women are much more likely to seek treatment for infertility than minority, bisexual or lesbian women, a new study finds.

Researchers examined data gathered from nearly 20,000 American women, aged 21 to 44, who took part in polls in 2002 and 2006-2010, conducted as part of the National Survey of Family Growth study.

In the first poll, 13 percent of white, heterosexual women said they sought treatment for infertility. This ranged from getting advice from doctors to more advanced measures such as fertility testing and drugs, surgery and artificial insemination.

In comparison, infertility treatment was sought by 7 percent of minority heterosexual women, 7 percent of white lesbian and bisexual women, and 1 percent racial minority lesbian and bisexual women.

The numbers in the second poll were 13 percent, 6 percent, 7 percent, and 7 percent, respectively, according to the study published recently in the journal Health Psychology.

"White, heterosexual women have apparently been the prime beneficiaries of the recent surge in medical infertility treatments," study author Bernadette Blanchfield, a doctoral student at the University of Virginia, said in a journal news release.

Lack of insurance was a major reason why minority lesbian and bisexual women didn't seek infertility treatments, the researchers found.

"There have been relatively few studies addressing the sexual and reproductive health of lesbian and bisexual women, but these findings reveal that sexual minority women do face inequities in fertility care. Further research on the access to and use of reproductive health care by lesbian and bisexual women is vital to understanding health disparities in the U.S.," Blanchfield said.

More information

The U.S. National Institute of Child Health and Human Development has more about fertility treatments for women.

Copyright © 2014 HealthDay. All rights reserved.


SOURCE: Health Psychology, news release, Aug. 18, 2014...

Sperm's Anti-Germ 'Shield' Might Play Role in Fertility
August 13, 2014

 

WEDNESDAY, Aug. 13, 2014 (HealthDay News) -- Preliminary new research points to the possibility that some infertile men could benefit from boosting a protein shield that protects sperm cells from germs.

While it's too early to know if the research will lead to any new treatments, one infertility expert said that any treatment would most likely be applied only to sperm used in the process of in-vitro fertilization.

Still, the expert, Gary Cherr of the University of California, Davis, noted that "this study adds another piece to the puzzle" surrounding men who are infertile for no apparent reason because it suggests something may be wrong with the germ-fighting sperm shield.

At issue in the new study are proteins known as defensins, which provide protection against germs. In particular, the researchers looked at one protein known as human beta-defensin 1, which is found in a variety of types of tissue in the body, "but its role in the male reproductive tract is not clear," said study co-author Hsiao Chang Chan, a professor at the school of biomedical sciences at the Chinese University of Hong Kong.

Other research has suggested that men may become less fertile if these proteins are missing. Cherr noted, "Sperm would need antimicrobial protection from microbes that are present in the female reproductive tract."

This fact raises the possibility that boosting the levels of the proteins would provide more protection against germs as sperm try to survive long enough to fertilize a female egg.

The new study tested this idea in the laboratory.

The researchers checked the levels of human beta-defensin 1 in the sperm cells of men who suffered from poor sperm motility (asthenozoospermia), meaning that their sperm don't move properly, or a fairly common infection within the genital tract known as leukocytospermia. The investigators found that the protein levels were lower than in men without fertility problems.

The researchers also boosted the levels of the protein in the sperm cells and found they moved more efficiently, had greater germ-fighting powers and could penetrate eggs more effectively.

Chan said the researchers included the sperm of 325 infertile men and 190 fertile men.

The next steps are to continue research and understand whether boosting the levels of the protein is safe, Chan noted.

Other questions remain as well.

Cherr, who studies infertility and is a professor of environmental toxicology and nutrition at UC Davis, said it's not clear why boosting human beta-defensin 1 on sperm would have an effect on fertility since the protein is found in the female reproductive tract also and would presumably fight germs there.

An estimated 10 percent to 15 percent of couples are infertile, the study authors noted. According to the American Society for Reproductive Medicine, men are fully or partially responsible for infertility in 40 percent of couples who are unable to conceive.

The study is published in the Aug. 13 issue of Science Translational Medicine.

More information

For more about infertility, visit the U.S. Centers for Disease Control and Prevention.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Gary Cherr, Ph.D., professor, departments of environmental toxicology and nutrition, University of California, Davis; Hsiao Chang Chan, Ph.D., professor, School of Biomedical Sciences, The Chinese University of Hong Kong; Aug. 13, 2014, Scien...

Lymphoma Treatment May Harm, Halt Men's Sperm Production
July 25, 2014

 

FRIDAY, July 25, 2014 (HealthDay -- Treatment for lymphoma may lower men's fertility, new research indicates.

Both Hodgkin lymphoma and non-Hodgkin lymphoma, which are cancers of the body's white blood cells, often affect young people who are still in their reproductive years. For men, treatment for these cancers can harm or halt sperm production. Although most men regain their fertility within two years of treatment, the researchers cautioned that men should be counseled about the possibility of this significant side effect before treatment begins.

"While many men can look forward to their fertility returning after treatment is over, not all will be so fortunate," Dr. Rebecca Sokol, president of the American Society for Reproductive Medicine, said in a society news release. "It is imperative that prior to the initiation of therapy, counseling and sperm preservation be made available to all lymphoma patients and their partners who may want to have children in the future."

In conducting the study, the researchers monitored the sperm of lymphoma patients undergoing various treatments to determine how each therapy affected the men's fertility. Specifically, they examined the sperm of 57 Hodgkin lymphoma patients and 18 non-Hodgkin lymphoma patients who used a sperm bank before starting their cancer treatment.

The researchers analyzed the men's sperm before treatment began as well as at three months, six months, 12 months and 24 months after treatment ended. The patients' sperm were compared to the sperm of 257 healthy, fertile men.

Even before treatment, the sperm of the men with lymphoma were more damaged than that of their healthy peers. These levels of damage improved between three and six months after treatment, but were still worse than the men in the control group.

Depending on their diagnosis, the men received combination chemotherapy, with or without radiation. Following treatment, their sperm density, total count, motility and vitality dropped. The lowest levels occurred three and six months after treatment.

The study, published recently in the journal Fertility and Sterility, revealed that alkylating chemotherapy was more often associated with a total halt in sperm production or a longer period of time for sperm production to resume. Alkylating chemotherapy damages DNA as it attacks cancer cells, to keep the cells from reproducing.

For all the men who received non-alkylating chemotherapy, with or without radiation, sperm production recovered between 12 to 24 months after treatment ended.

Two years after treatment ended, the researchers noted that sperm production had not recovered for 7 percent of the men in the study.

More information

The American Cancer Society provides more information on lymphoma.

Copyright © 2014 HealthDay. All rights reserved.


SOURCE: The American Society for Reproductive Medicine, news release, July 22, 2014...

Study Links Vasectomy to Aggressive Prostate Cancer
July 10, 2014

 

THURSDAY, July 10, 2014 (HealthDay News) -- Men who have a vasectomy may be at increased risk for aggressive prostate cancer, a new study suggests.

But the risk is comparatively small, the researchers acknowledged. And several urologists not involved with the study said more research is needed to determine if the study findings are truly accurate.

For the study, Harvard researchers analyzed data from more than 49,400 American men who were followed for 24 years, starting in 1986. During that time, 6,023 cases of prostate cancer were diagnosed among the men, including 811 fatal cases.

The 25 percent of the men in the study who'd had a vasectomy had a 10 percent increased risk of developing prostate cancer, according to the study published online July 7 in the Journal of Clinical Oncology.

Vasectomy was not linked with an increased risk of low-grade prostate cancer. But it was associated with a 20 percent higher risk of advanced prostate cancer and a 19 percent greater risk of fatal prostate cancer, respectively, the study authors said.

Even among men who had regular prostate-specific antigen (PSA) screening tests for prostate cancer, those who had a vasectomy were 56 percent more likely to develop fatal prostate cancer. This link was strongest among men who had a vasectomy at a younger age.

However, the absolute risk of developing deadly prostate cancer was small, the study authors noted -- 16 of every 1,000 men.

"This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19 additional years of follow-up and tenfold greater number of cases. The results support the hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate cancer," study co-author Lorelei Mucci, associate professor of epidemiology at the Harvard School of Public Health, said in a university news release.

About 15 percent of men in the United States have a vasectomy. Prostate cancer is the second leading cause of death among American men, although most men diagnosed with the disease don't die from it.

"The decision to opt for a vasectomy as a form of birth control is a highly personal one and a man should discuss the risks and benefits with his physician," study co-author Kathryn Wilson, a research associate in the department of epidemiology, said in the university news release.

Dr. Louis Kavoussi is chairman of urology at North Shore-LIJ Health System in New Hyde Park, N.Y. He said: "I would be cautious about applying these findings to clinical practice right now. This is not like cigarette smoking causing a large number of people to develop lung cancer. This is a small increase in the risk of prostate cancer. I think further studies really need to be mandated in a better controlled fashion.

"There are a whole host of potential unknown reasons why this potentially could be real," he added. "On the other hand, this is a retrospective study -- a backwards-looking study over many, many years, and the increased risk is small. So can this be an error in statistics? There are many papers over the years that don't show a correlation with this."

Dr. Aaron Katz, chairman of urology at Winthrop-University Hospital in Mineola, N.Y., suggested that men who've undergone a vasectomy may simply have their cancers caught more often because they see their doctor more often.

"Several studies have looked at the association between vasectomy and prostate cancer. It is well known that men who have had a vasectomy are more likely to be seen more frequently by urologists in follow-up than men who never had a vasectomy, and will undergo more frequent PSA testing," he said.

The Harvard researchers said they were able to compensate for factors such as more frequent visits to doctors before reaching their conclusions.

Kavoussi added: "The implications of this study, if it becomes dogma, can be quite profound in society. All of a sudden birth control has been pushed entirely onto women. There are potential side effect issues with birth control for women as well."

Support for the study was provided by grants from the U.S. National Cancer Institute, among other sources.

More information

The U.S. National Library of Medicine has more about prostate cancer.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Harvard School of Public Health, news release, July 9, 2014; Louis Kavoussi, M.D., chairman of urology, North Shore-LIJ Health System, New Hyde Park, N.Y.; Aaron Katz, M.D., chairman of urology, Winthrop-University Hospital, Mineola, N.Y....

Sperm Donor Age May Not Affect Infertility Treatment Success: Study
June 30, 2014

 

MONDAY, June 30, 2014 (HealthDay News) -- A sperm donor's age doesn't affect the chances of a live birth resulting from fertility treatments using donor sperm, a new study says.

There is emerging evidence that sperm quality declines as men age. However, the new study's findings support previous research showing that a couple's chances of having children are much more dependent on the age of the female than of the male, researchers said.

The results also show that the quality of donor sperm -- rather than the donor's age -- is the important factor in the success of fertility treatments, the study authors said.

"It's sperm quality rather than male age that matters," said principal investigator Dr. Meenakshi Choudhary, from the Newcastle Fertility Centre at Life, Newcastle upon Tyne, United Kingdom.

The researchers analyzed more than 39,000 first fertility treatment cycles with donated sperm that were performed in the United Kingdom between 1991 and 2012. The treatment included either in-vitro fertilization (IVF) or donor insemination.

The live birth rate from IVF was about 29 percent among women ages 18 to 34 and about 14 percent among women over age 37. However, there was no link between the live birth rates in these two age groups and the age of the sperm donors.

Similar findings were made for donor insemination, according to the study that's to be presented this week at the annual meeting of the European Society of Human Reproduction and Embryology, in Munich, Germany. Research presented at meetings are generally considered preliminary until published in a peer-reviewed journal.

"Our results suggest that, up to the age of 45, there is little effect of male age on treatment outcome, but sperm donors are a selected population based on good sperm quality," Choudhary said in a society news release.

"Our study shows that we are good at selecting the right sperm donors with the right sperm quality -- and that's why we found no difference in live birth rate despite the increasing age of sperm donors. This confirms the view that a man's age doesn't matter in achieving a live birth provided his sperm quality is good," she said.

More information

The U.S. National Institute of Human Health and Child Development has more about infertility treatments.
Copyright © 2014 HealthDay. All rights reserved.


SOURCE: European Society of Human Reproduction and Embryology, news release, June 29, 2014...

Cellphone Exposure May Harm Male Fertility
June 10, 2014

 

MONDAY, June 9, 2014 (HealthDay News) -- Men who carry a cellphone in their pants pocket may harm their sperm and reduce their chances of having children, a new review warns.

The research team analyzed the findings of 10 studies that examined how cellphone exposure may affect male fertility. Among men with no exposure to cellphones, 50 percent to 85 percent of their sperm had a normal ability to move towards an egg.

That fell by an average of 8 percent among men exposed to cellphones. Similar effects were seen for sperm viability, which refers to the proportion of sperm that were alive, according to the study published June 9 in the journal Environment International.

The effects of cellphone exposure on sperm concentration (the number of sperm per unit of semen) were unclear, the investigators noted.

Most adults worldwide own mobile phones, and about 14 percent of couples in middle- and high-income nations have difficulty conceiving, the researchers said. They also noted that previous studies have suggested radio-frequency electromagnetic radiation emitted by cellphones can harm male fertility.

"Given the enormous scale of mobile phone use around the world, the potential role of this environmental exposure needs to be clarified," study leader Fiona Mathews, of the biosciences department at the University of Exeter in England, said in a university news release.

"This study strongly suggests that being exposed to radio-frequency electromagnetic radiation from carrying mobiles in trouser pockets negatively affects sperm quality. This could be particularly important for men already on the borderline of infertility, and further research is required to determine the full clinical implications for the general population," she said.

While the study found an association between cellphone exposure and male infertility, the study was not designed to determine a cause-and-effect relationship.

More information

The U.S. National Library of Medicine has more about male infertility.


SOURCE: University of Exeter, news release, June 9, 2014...

Health Highlights: June 5, 2014
June 05, 2014

 

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Senators Craft Bill to Help Veterans Get More Timely Medical Care

A Senate bill designed to help U.S. veterans get more timely medical care was unveiled Thursday.

The bipartisan legislation is a response to a growing scandal within the Department of Veteran Affairs following reports that long waiting lists may have led to some veterans dying while awaiting treatment, and that records were then falsified to cover up the treatment delays.

Meanwhile, Veterans Affairs Acting Secretary Sloan Gibson confirmed on Thursday that more than 100,000 veterans nationwide were kept off waiting lists, and that an additional 18 veterans in the Phoenix area who were kept off an official electronic appointment list have since died, USA Today reported.

The Senate accord would allow the acting veterans affairs secretary to fire senior officials who may be culpable, and it would help expand health care services for veterans who are still waiting for needed medical care, the New York Times reported.

The accord was crafted by Sen. Bernie Sanders (Ind-Vt.), chairman of the Senate Veterans Affairs Committee, and Sen. John McCain (R-Ariz), the Times reported.

"We have learned that in many parts of this country veterans cannot get the timely care that they need," Mr. Sanders said. "So this bill in a significant way begins to address that important issue."

Under the proposal, veterans who are stuck on waiting lists or who live more than 40 miles from a VA medical center could go to private doctors for health care services, and the VA would pay their medical bills. The VA would also be allowed to lease 26 major medical facilities in 18 states and Puerto Rico to try to treat the backlog of patients, the Times reported.

The bill would also give the VA $500 million to more aggressively recruit and retain doctors. And the deal includes a measure to improve the delivery of care to veterans who were victims of sexual assault while in the military, according to the Times.

Last month, the House passed a much narrower bill that would give the Veterans Affairs Secretary the authority to fire or demote senior executives without going through a cumbersome federal review process.

-----

Catholic Group Wins Temporary Exemption From Contraception Provision

Nearly 200 Catholic organizations and employers -- including archdioceses -- have been granted a temporary exemption from complying with a provision of the Affordable Care Act that requires employers to offer insurance coverage for contraceptives.

U.S. District Judge David Russell of Oklahoma City granted the injunction on Wednesday. It exempts the Catholic groups from fines or penalties that might be levied for not complying with the contraception provision of the Affordable Care Act while their objections are argued in lawsuits, the Associated Press reported.

In March, the Catholic Benefits Association -- which includes archdioceses, an insurance company and a nursing home across almost 2,000 Catholic parishes nationwide -- filed a lawsuit stating that the provision was a violation of its religious objections to contraception and abortion-inducing drugs, the AP said.

"The harm posed to these plaintiffs absent relief is quite tangible -- they will either face severe monetary penalties or be required to violate their religious beliefs," Russell said.

A Justice Department attorney who represented the government declined to comment Thursday on the ruling.

Catholic officials embraced the judge's decision.

"The [Obama] administration has already effectively granted exemptions from the mandate to various employers whose plans cover more than 130 million employees," Oklahoma City Archbishop Paul Coakley said in a statement, the AP reported. "We're simply seeking the same exemption for Catholic employers who have religious objections to the unjust requirements of the mandate."

Baltimore Archbishop William Lori, president of the Catholic Benefits Association, said the group was created to help Catholic employers provide quality health care benefits that complied with church teaching, the AP reported.

Hobby Lobby, a chain of arts-and-crafts stores that also objects to the contraception provision on religious grounds, won a similar ruling in the same federal court and at the 10th U.S. Circuit Court of Appeals, according to the news service.

The U.S. Supreme Court heard oral arguments in the Hobby Lobby case in March but has yet to issue a ruling, the AP said.

-----

Many 'Inconsistencies' in Obamacare Sign-Ups: Report

A new government document finds that more than a quarter of the 8 million people who signed up for coverage under the Obama Administration's new health care law have "inconsistencies" in the data they supplied.

As reported by the Associated Press, U.S. Department of Health and Human Services (HHS) documents obtained by the news agency show discrepancies between information supplied by at least 2.1 million new enrollees and data already on file with the federal government. Most of these discrepancies involve issues such as citizenship, immigration and income, the AP said.

Income discrepancies accounted for about 1.2 million cases, while immigration data issues affected 505,000 and conflicts with citizenship information involved 461,000, the AP reported.

The problem is creating a logjam of paperwork for the government, but officials say they hope to have most of that cleared later this summer. Julie Bataille, communications coordinator for the launch of the new health care reform package, said many of the inconsistencies are tied to outdated information in government files.

"The fact that a consumer has an inconsistency on their application does not mean there is a problem on their enrollment," Bataille told the AP. "Most of the time what that means is that there is more up-to-date information that they need to provide to us."

However, the AP noted that the 2.1 million figure doesn't include people who signed on to Obamacare via state-run websites, so the number of problematic enrollments might be much higher.

About 5.4 million people signed up through the federal website, while 2.6 million more enrolled through state-run websites.

Consumers whose applications have been flagged as having discrepancies will be notified by the HHS with a request for new or updated information. Right now, there is a 90-day window in place to clear up any discrepancies, but the Obama administration has the option to extend that window, the AP said.


...

Pot Use Might Be Linked to Abnormal Sperm
June 05, 2014

 

THURSDAY, June 5, 2014 (HealthDay News) -- Marijuana use might affect the size and shape of a young man's sperm, possibly impairing his fertility, a new study claims.

"Our data suggests that cannabis users might be advised to stop using the drug if they are planning to try and start a family," study author Dr. Allan Pacey, a senior lecturer at the University of Sheffield in England, said in a university news release.

"Our knowledge of factors that influence sperm size and shape is very limited, yet faced with a diagnosis of poor sperm [size and shape], many men are concerned to try and identify any factors in their lifestyle that could be causing this," said Pacey.

The study, published June 5 in the journal Human Reproduction, doesn't prove that pot use impairs male fertility; it only suggests an association between the two.

The research included nearly 2,000 men who visited one of 14 fertility clinics and answered questions about their medical history and their lifestyle.

Of that group of men, 318 had sperm that was considered "abnormal." Less than 4 percent of their sperm was the correct size and shape, the researchers said. The information collected on these men was compared to data from the remaining 1,652 men who had sperm that was considered "normal."

The researchers examined how certain lifestyle choices affected the size and shape of the men's sperm and found "very few identifiable risks," Pacey said.

Although cigarettes and alcohol had little effect, the study revealed that sperm size and shape was negatively affected if the men were younger than age 30 and had smoked marijuana within three months.

Sperm samples produced during the summer were also nearly twice as likely to be considered "abnormal," the study showed.

The study authors noted that sperm size and shape may be linked to other factors that were not measured, such as the quality of a man's DNA.

Previous research has suggested sperm need to be of good size and shape to work their way through a woman's body after sex and fertilize an egg.

Men exposed to paint strippers and lead are also at risk of having sperm with poor shape and size, Nicola Cherry, an epidemiologist and professor formerly of the University of Manchester in England, said in the news release.

More information

The U.S. National Institute on Drug Abuse provides more information on the health effects of marijuana use.Copyright © 2014 HealthDay. All rights reserved.


SOURCE: University of Sheffield, news release, June 4, 2014...

Do Stressed-Out Men Have Weaker Sperm?
May 30, 2014

 

FRIDAY, May 30, 2014 (HealthDay News) -- A small new study suggests that higher levels of stress may hurt the quality of men's sperm, potentially making it more difficult for them to impregnate women.

The findings aren't definitive and don't prove cause-and-effect, since it's possible that stressed-out men share another trait that disrupts their reproductive systems. Also, it's not clear if men with more stress are actually less fertile.

Still, "men who reported a higher number of stressful events happening in their life, or those who reported feelings of stress, had a lower percentage of sperm that moved well or were formed correctly, as well as lower numbers of sperm," said study lead author Teresa Janevic, an assistant professor at Rutgers School of Public Health's Department of Epidemiology in Piscataway, N.J. "Lower values of each of these measures are associated with lower fertility because of their reduced ability to fertilize an egg."

Prior research has linked stress to lower quality of semen, the fluid that contains sperm. But, "the results are not consistent across studies, and this is likely due to different populations and varied methods of measuring stress in these studies," said Audra Gollenberg. She is an assistant professor of public health at Shenandoah University College of Arts and Sciences in Winchester, Va., and was not involved in the new research.

The study was designed to "really get to the bottom of the question how stress is influencing the reproductive health of average men," Janevic said.

The researchers tracked 193 healthy men aged 38 to 49 from northern California who agreed to take part in a study and provide semen samples at a clinic. The men also answered questions about their levels of overall life stress and their stress at work.

The design of the study doesn't allow the researchers to link specific levels of stress to specific effects on sperm, Janevic said. And she added that "small increases in stress may not to be important for the semen quality in any individual man."

However, the study did find that men who were stressed in general had more dysfunctional sperm. This held true even after the researchers adjusted their statistics so they wouldn't be thrown off by traits like age, education level or race.

The researchers did not find a connection between work stress, specifically, and the quality of a man's sperm. "It's very possible that the levels of work stress in the men in our study were not high enough to see an effect," Janevic said. She did note that sperm were in worse shape in unemployed men compared to men who had jobs.

Gollenberg, the Shenandoah University professor, said other research has been inconsistent about the question of whether work stress might affect sperm quality.

"Work stress may be a different beast than life events, which are thought to be more traumatic and long-lasting," she said. "Some individuals are greatly affected by work stress, whereas others are able to leave 'work at work.'"

What might be going on biologically? It's not clear how a man's stress might affect his sperm, although scientists suspect that it has something to do with brain chemicals and testosterone. One theory suggests that stress in pregnant mothers could translate to sperm problems in their sons when they encounter stress, decades later.

So, what can stressed-out men do to ensure highly fertile sperm? The new findings don't say.

"We didn't study whether stress reduction can increase chances of conception," Janevic said. "However, stress reduction can contribute to health in various ways, and men can't go wrong to limit stress when possible as part of an overall healthy lifestyle."

Gollenberg pointed out that stress now won't necessarily translate to more sperm troubles now, since it takes about 2.5 months for sperm to develop. "Stress right now will affect semen quality in the next several months," she said.

The study was published online May 29 in the journal Fertility and Sterility.

More information

There's more on male infertility at the American Urological Association.
Copyright © 2014 HealthDay. All rights reserved.


SOURCES: Teresa Janevic, Ph.D., MPH, assistant professor, department of epidemiology, Rutgers School of Public Health, Piscataway, N.J.; Audra Gollenberg, assistant professor of public health, Shenandoah University College of Arts and Sciences, Winchester...

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