Infertile women more willing to take risks

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.

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Lifestyle factors and miscarriage

A Danish nationwide study has found that perhaps as many as 1 in 4 miscarriages can be prevented by changes in lifestyle. The study identified the risk factors in more than 90,000 pregnancies and found that older age, being underweight or overweight before pregnancy, and alcohol consumption, lifting heavy weights (> 20 kg), and night work during pregnancy were all linked to an increased risk of miscarriage before 22 weeks of pregnancy.
Most of these are lifestyle factors that can be adjusted before trying for a baby. We can't turn back time of course and one of the highest risk factors of all, older age, is not something that can be reversed. Nevertheless, the investigators of the study point out that the trend for women to delay childbearing is something that can be changed through good education programmes.

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Young IVF adults are healthy

A new study, the largest one of its kind so far, has confirmed that the long-term health outcomes of children conceived following IVF are good. This research was carried out in collaboration with Monash IVF and concluded that the physical and mental health of more than 500 young 'IVF' adults was generally the same as the naturally conceived control population. Their educational achievements were also similar.
The study, led by Prof Halliday, did find that IVF-conceived offspring had higher rates of asthma, hay fever and hospitalisation in their first 18 years of life. It is at this stage unclear whether this is due to the IVF treatment per se or perhaps to different parenting behaviours. It has indeed been suggested that the rising number of asthma sufferers worldwide is perhaps linked to a drop in the exposure to germs in the environment (the hygiene hypothesis).

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Not all lubricants are the same

Intimate lubricants are often used by couples during sexual intercourse to reduce friction and to make penetration less uncomfortable. In this recently published study, researchers looked at a variety of different lubricants and their effect on sperm function in laboratory conditions.
Sesame oil and synthetic coital lubricants, such as Astroglide and KY products, were found to impair sperm movement and may thus reduce fertility. Pre-Seed and canola, mustard and baby oils showed no such harmful effects and may therefore be considered more sperm-friendly lubricants.
After exposure to mustard oil the sperm showed signs of hyperactivation, which is a much more active type of swimming that may help the sperm to penetrate the egg. If sperm is exposed to mustard oil lubricant, this hyperactivation would happen in the vagina. It is not clear whether this is a good thing because normally sperm hyperactivation is believed to occur in the Fallopian tube, which is much further up in the genital tract.

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Uterine infusion to stimulate stem cells doesn't work.

A new randomised controlled trial has shown that a drug used to stimulate stem cells in the endometrium (uterine lining) has no effect on the thickness of the lining or the chance of getting pregnant with IVF.
Granulocyte colony-stimulating factor, sold under the name Filgrastim, was injected as a solution into the uterine cavity. Compared to women who were injected with a saline solution there was no improvement in the thickness of the lining or the pregnancy rates.

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Shift work linked to reduced fertility

Dr Linden Stocker from the University of Southampton, UK, recently presented the conclusions of a meta-analysis that pooled data from research studies published between 1969 and January 2013 that looked at the effect of shift work on health.
The analysis, which covered nearly 120,000 women, found those working shifts had an 80% higher rate of fertility problems, and a 33% higher rate of disrupted menstrual periods compared to women working regular hours.

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Caesarean section linked to endometriosis

Caesarean sections may be associated with an increased risk of endometriosis compared with vaginal deliveries, a Swedish study suggests. Women who had caesarean sections had an 80% higher risk of endometriosis after their first delivery compared with those who had vaginal deliveries.

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