Can flu shots help women get pregnant? That is the question being discussed in the top journal Science this week. Professor Sarah Robertson, a world expert on immunology in reproduction from the University of Adelaide, is excited. She has previously warned that the indiscriminate use of corticosteroids in IVF is unsafe and ineffective but she can see how the flu shots may deliver on two fronts: protecting women against the flu and improving their chances to get pregnant.
Yesterday the Sydney Morning Herald picked up on an article By Prof Sarah Robertson, Australia's most eminent reproductive immunologist. In her article Prof Robertson warns against the use of corticosteroids such as prednisolone in IVF. There is virtually no evidence that corticosteroids improve live birth rates but we know they are associated with significant risks.
I have spent some time with other IVF specialists visiting the IVF unit in Brussels where the sperm micro-injection technique, aka ICSI, was invented in 1992.
It was great catching up with friends and colleagues and having the opportunity to discuss some of the latest developments in our field.
Researchers conducting a study in 273 women undergoing IVF at Massachusetts General Hospital Fertility Center in Boston, USA, report that there was a beneficial effect on live birth rates after certain types of vigorous exercise such as aerobics, rowing, and on the ski or stair machine.
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.