Women treated for vaginal thrush had an increased risk of miscarriage if they had been taking the antifungal drug fluconazole by mouth. An analysis of 1.4 million pregnancies in Denmark published in JAMA compared women taking the drug by mouth or vaginally. Oral use of this drug was associated with a 60% increase risk of a miscarriage compared to women taking the vaginal medication. The intravaginal formulations of antifungals are usually the first line treatment for pregnant women, but oral fluconazole is used in cases of recurrence or severe symptoms or when topical treatment has failed.
Traditional Chinese medicines are considered by some as a more natural, herbal approach to treating medical conditions, including fertility problems. It is estimated 50 per cent of Australians have used alternative therapies at some point. But there are renewed concerns about the safety of the multi-billion-dollar business.
An ABC news story reports on a study carried out by Curtin University, Murdoch University and the University of Adelaide which has now found that 90 per cent of 26 widely available Chinese medicines tested were not fit for human consumption.
Half contained illegal substances, including toxic metals, prescription medications, stimulants and animal DNA, none of which were listed on the product's label.
Murdoch University biochemist Dr Garth Maker said that over-the-counter drugs like paracetamol and ibuprofen were found in the Chinese herbs but also steroids, blood thinner warfarin and even sildenafil, the active ingredient in Viagra. "We were surprised but at the same time, there definitely seems to be an element of deception in designing these things to have a specific outcome," he said. "They may contain ephedrine, which will give a lot of people a buzz, and therefore they feel good and they think 'this is fantastic medicine, I should keep taking it'."
Professor Bunce of Curtin university added "One herbal medicine that's for sale had trace amounts of snow leopard DNA in it. We also found DNA from pit vipers, frogs and trace amounts of cat and dog DNA." It is unclear whether manufacturers intended these extra ingredients to be mixed in or whether they are contaminations resulting from poor manufacturing processes.
Professor Bunce also said that each herbal medicine sold in Australia needs to be listed with the Therapeutic Goods Administration (TGA), but only 12 of the products tested were registered with the agency and are deemed "low-risk". The remaining 14 were not registered by the TGA and therefore should not be available to Australian consumers in a commercial quantity.
Visanne, a drug developed by Bayer, has been available to endometriosis patients overseas for quite a while now. Unfortunately, for a variety of reasons, including commercial ones, Bayer decided not to bring the drug to Australia despite having had the drug successfully registered with the Australian Therapeutics Goods Administration.
Now a public awareness campaign by Syl Freedman, a long-suffering endometriosis patient, has been successful in persuading Bayer to reverse their decision. The drug is expected to be available early 2015.
The U.S. research group of Richard Scott Jr. has published a well-designed randomised controlled study that looked at the potential benefit of a small intra-uterine infusion of the pregnancy hormone, hCG.
The idea behind this study was that the embryo secretes hCG to tell the endometrium to become more receptive. The researchers hoped that by infusing extra hCG in the uterine cavity they could make the endometrial lining even more receptive.
A logical and promising idea but ...Read More
Although it is too soon to know for sure, there is growing evidence that it may be better for mother and baby to postpone a fresh embryo transfer and to freeze all embryos. Studies have shown that ovarian stimulation in an egg retrieval cycle has a negative impact on the endometrium (the lining in the uterus). Although good success rates can be achieved by transferring a fresh embryo, new evidence suggests that frozen embryo transfers result in better outcomes.
Our research project on health numeracy and risk behaviour was presented at the annual Congress of the Asia Pacific Initiative on Reproduction in Brisbane last week.The study explored how much a person's ability to understand health statistics, such as the risk that a complication may occur, would influence their decision making in IVF.The findings suggest that being comfortable with numbers and statistics helps patients make better informed decisions. Another significant finding is that infertile women tend to be more worried about complications during pregnancy and they also overestimate those risks.
Despite these concerns, women with infertility are more likely to take extra risks, such as transferring two embryos at the same time. Double embryo transfers are associated with a higher risk of multiple pregnancy and this leads to poorer outcomes for the mother but also for the baby. Multiple pregnancies increase the risk of miscarriage, stillbirth and cerebral palsy.
The importance of the study is that a better understanding of what influences risk behaviour can help IVF specialists and counsellors tailor the information that is provided to the needs of the patient.