National Action Plan on Infertility Released
Posted by on July 16, 2014 - 1:50pm

The Centers for Disease Control and Prevention released the final version of its National Public Health Action Plan for the Detection, Prevention and Management of Infertility.  The National Action Plan developed over the course of seven years and began with an ad hoc working group that included members of the Oncofertility Consortium that started at Northwestern.    A draft National Action Plan was released in May 2012. ASRM provided input at each step of process under which the National Action Plan was developed and will continue to be involved as the National Action Plan is implemented.

The goals of the National Action Plan are to:

• Promote healthy behaviors to maintain and preserve fertility;

• Promote prevention and early detection and treatment of medical conditions that can threaten fertility; and

• Reduce exposures to environmental, occupational, infectious and iatrogenic agents that can threaten fertility.

The National Action Plan is available at www.cdc.gov/reproductivehealth/Infertility/PublicHealth.htm.

The CDC will host a Public Health Grand Rounds on August 19, 2014 on infertility.
For more information please see www.cdc.gov/cdcgrandrounds.

Acupuncture and Women's Health
Posted by on March 18, 2014 - 2:56pm

Acupuncture has been used in Eastern countries to address women's health issues but is not readily adopted in the U.S. especially by the medical establishment.   A new study reports preliminary data indicating that acupuncture may improve menstrual health and overcome delays in becoming pregnant. There are experimental data indicating that acupuncture can influence female reproductive functioning, although the actual mechanisms involved are not yet clarified. Acupuncture is a complex intervention yet the evaluation of acupuncture research designs and outcome measures expect a level of commensurability difficult to achieve in complex interventions. A focus on effectiveness rather than efficacy may be a solution. Further research  is needed that includes the rich traditions of acupuncture practice and the rigorous methods of evidence-based research.

Source:   International Journal of Women's Health 17 March 2014.

If infertility is an issue, share your journey!
Posted by on June 4, 2013 - 3:25pm

I think women want to feel independent, that we can conquer the world on our own.  Sometimes it can be hard to ask for help.

Having issues getting pregnant can be one of those times.  Most of us assume that it’s easy; you get off birth control, have sex, and you're pregnant! However, for many women, especially those who delay their first pregnancy until they are older,  getting pregnant can be anything but easy.

Struggling to get pregnant and going through infertility treatments is stressful; it can be a lonely time.  No one should have to go through it alone!

Support groups can be an amazing resource for women while on their infertility journey.  It can be therapeutic to open up and share your feelings and your fears with peers who understand and are going through the same experience.

My own personal journey through infertility inspired me to create a unique support community called Shine (www.shinechicago.com);  group sessions combine peer support as well as professional guest speakers from the women’s health community.

From my own experience, I can say first hand how important support is while going through a difficult time.  Your partner is your first layer of support, but it can be helpful and healthy to have another place to turn, both for your own emotional health and the health of your relationship.

So know it’s okay to be vulnerable, it’s okay to reach out for help, it’s okay to open up about your story!  One of my favorite quotes relates so well to infertility: “strength doesn’t come from what you can do, it comes from overcoming the things you once thought you couldn’t.”

Guest blogger: Katie O'Connor (Founder, Shine Chicago: a ray of light on infertility)

TEDxNU event: A great success!
Posted by on June 20, 2012 - 12:06pm

Thank you to all who attended TEDxNU: The Complex World of Fertility last night. We had a great time listening to the speakers and even got a chance to see some entertaining and enlightening clips from other TED talks. A special thanks to Sharon Green, the emcee for the evening, and to Dr. Uzzi, Dr. O'Halloran, and Dr. Woodruff, who blew us away with their discussions of collaborative science, reproductive health, and breakthroughs in fertility preservation research.

Are you interested in the mystery of life?  Complexity science?  Infertility? Or the changing process of scientific discovery? Are you a TED or TEDx fan? Check out the webcast videos from this event that will be posted to our website and on this blog in a couple of weeks. To learn more about the topics and speakers, visit www.tedx.northwestern.edu.

Circadian cycle can impact women trying to have babies
Posted by on May 31, 2012 - 6:05am

A new study shows that the biological clock is not the only clock women trying to conceive should consider. The circadian clock needs attention, too.

Epidemiological studies have shown female shift workers, such as nurses, and female flight attendants who work on long-distance east-west routes (i.e., those with constant jet lag) have fertility and menstrual issues. They are habitually out of sync with the external light cycle. But the role circadian rhythm disruption may play in their reproductive problems is a poorly studied area.

Research led by Northwestern U. circadian rhythm expert Fred W. Turek now draws a clear line between disrupted circadian rhythms and reproductive physiology. Turek and his colleagues are the first to show that if you disrupt the circadian clock environmentally in mice, with repeated changes in their light-dark cycles, there are problems with pregnancy outcomes.

And the effect can be dramatic. The researchers found evidence suggesting the severity of circadian disruption may be linked to the severity of pregnancy disruption: mice subjected to advances of the light-dark cycle had greater circadian clock disruption and lower reproductive success. This group’s pregnancy success rate was only 22 percent.

The study was published today in the journal PLoS ONE.

“Our results have important implications for the reproductive health of female shift workers, women with circadian rhythm sleep disorders and/or women with disturbed circadian rhythms for other reasons,” Turek said.

“If you disrupt your internal rhythms, there will be negative consequences -- that is very clear,” said Keith Summa, first author of the paper and an M.D./Ph.D. candidate working in Turek’s lab. “Our results suggest people should consider their biological rhythms for optimal health.”

The repeated shifting of the light-dark cycle shifts the biological clock throughout the body. This environmental disturbance is more relevant to shift workers and those frequently flying across time zones, the researchers note, than genetic disruption of the circadian clock, which also negatively influences reproductive function.

Turek, Summa and their colleague and co-author Martha H. Vitaterna studied three sets of normal laboratory female mice, all who had recently mated. The study was conducted over the course of 21 days, the duration of a typical pregnancy.

One set was a control group of 12 mice that experienced normal days of 12 hours of light, followed by 12 hours of darkness. The two other groups, of 18 mice each, also experienced days of 12 hours of light and 12 hours of darkness. But the phase-advanced group had its 12 hours of light start six hours earlier every five days. The phase-delayed group had its light start six hours later every five days. (There were a total of four phase shifts over the duration of the study.)

The researchers monitored the mice throughout the gestation period to count the number of full-term pregnancies. The results surprised them.

In the control mice, 90 percent of the matings led to full-term pregnancies. But in the phase-delay group, the pregnancy success rate was 50 percent, while in the phase-advanced group, it was only 22 percent.

“We were surprised at how dramatic the effect of manipulating the light-dark cycle was, especially in the phase-advanced group,” Summa said. “We expected a negative effect from the circadian clock disruption, but not this much.”

They next looked at a separate group of females in the phase-delay and phase-advance protocol to see how the animals responded to the repeated phase shifts. The researchers found the phase-advanced animals required one to two days longer, on average, to return to normal rhythms. This suggests the magnitude of circadian disruption is associated with the severity of pregnancy loss.

The next steps, the researchers say, are to identify specifically the stage at which pregnancy is affected and to understand exactly how circadian disruption results in the observed adverse effects.

“We’ve made an interesting observation, but what’s causing the reduced fertility?” Summa said. “We would like to determine where exactly the phase shifts and internal rhythm disruptions are having an effect.”

The March of Dimes Foundation and the Institute for Women’s Health Research at Northwestern University (the sponsor of this blog) supported the research.

The paper is titled “Environmental Perturbation of the Circadian Clock Disrupts Pregnancy in the Mouse.”

Megan Fellman is the science and engineering editor. Contact her at fellman@northwestern.e

Gaps in chlamydia testing among young women should be avoided
Posted by on March 17, 2012 - 11:53am

Just 38 percent of sexually active young women were screened for chlamydia in the previous year, according to the most recent nationally representative estimate conducted by the Centers for Disease Control and Prevention. CDC recommends annual screening for all sexually active women aged 25 and under.

Overall testing rates remain low, although testing was most common among African-American women, those who had multiple sex partners, and those who received public insurance or were uninsured. Researchers find this encouraging because these are some of the groups at highest risk for chlamydia.

“This new research makes it clear that we are missing too many opportunities to protect young women from health consequences that can last a lifetime,” said Kevin Fenton, M.D., director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “Annual chlamydia screening can protect young women’s reproductive health now and safeguard it for the future.”

Chlamydia is the most commonly reported infectious disease in the United States, and young people are most affected. Because people often do not have symptoms, many infections go undetected and untreated. Untreated chlamydia can have severe long-term health consequences, particularly for young women, including chronic pelvic pain, potentially fatal ectopic pregnancy and infertility.

CDC recommends that anyone diagnosed with chlamydia be retested three months after initial treatment to ensure that those who may have become reinfected can be promptly treated with antibiotics. However, additional data show that retesting rates remain low and many reinfections likely are being missed. By examining available data on more than 60,000 men and women who tested positive for chlamydia CDC  found that just 14 percent of men and 22 percent of women were retested within 30-180 days. Of those who were retested, a significant proportion again tested positive (25 percent of men and 16 percent of women).

“It is critical that health care providers are not only aware of the importance of testing sexually active young women every year for chlamydia infections, but also of retesting anyone who is diagnosed,” said Gail Bolan, M.D., director of the CDC’s Division of STD Prevention. “Chlamydia can be easily treated and cured with antibiotics, and retesting plays a vital role in preventing serious future health consequences.”

 

 

Younger Women at Risk for Pelvic Inflammatory Disease
Posted by on December 2, 2010 - 10:11am

Pelvic inflammatory disease (PID) refers to infection of the uterus (womb), fallopian tubes and other reproductive organs that causes symptoms such as lower abdominal pain.   It is a serious complication of some sexually transmitted diseases, especially chlamydia and gonorrhea.   PID can damage the fallopian tubes and tissues in and near the uterus and ovaries and can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside the womb), abscess formation and chronic pelvic pain.

More than 750,000 women in the US experience an episode of acute PID every year.

PID occurs when bacteria move upward from a women's vagina or cervix into her reproductive organs.   A prior episode of an PID increases the risk of another episode because the reproductive organs may be damaged during the initial bout of infection.

Sexually active women in their childbearing years are most at risk, and those under age 25 are more likely to develop PID than those older than 25.   This partly because the cervix of teenage girls and young women is not fully matured, increasing their susceptibility to the STDs that are linked to PID.   The more sex partners a women has, the greater her risk of developing PID.   Also, a woman whose partner has more than one sex partner is at greater risk of developing PID, because of the potential for more exposure to infectious agents.   Women who douche may have a higher risk of developing PID.   Research has shown that douching changes the vaginal flora in harmful ways, and can force bacteria into the upper reproductive organs.

Women who have an intrauterine device (IUD) inserted may have a slightly increased risk of PID near the time of insertion compared with women using other contraceptives or no contraceptive at all.  However, this risk is greatly reduced if a women is tested and, if necessary, treated for STDs before an IUD is inserted.

Signs and symptoms of PID include:

  • lower abdominal pain
  • fever
  • unusual vaginal discharge that may have a foul odor
  • painful intercourse
  • painful urination
  • irregular menstrual bleeding
  • pain in the right upper abdomen.

If the PID is caused by a chlamydial infection, a woman may only have mild symptoms or even no symptoms.   This often leads to an undiagnosed case of PID which can become a serious problem.

To read more about the causes,  diagnosis, treatment and complications of PID, click HERE.

Source:   Centers for Disease Control and Prevention

More on Endometriosis
Posted by on September 21, 2010 - 9:27am

For some unknown reason, we are suddenly receiving a lot of comments on our March 2010 posting on Endometriosis.    Maybe it is because endometriosis is one of the most common gynecological diseases, affecting more that 5.5 million women in North America alone.   There is a comprehensive fact sheet available from the National Institute of Child Health and Human Development on this topic that is very helpful.    Click here to view the information.

Stress and Infertility
Posted by on August 30, 2010 - 8:47am

A study by researchers at the National Institutes of Health (NIH) and the University of Oxford supports the widespread belief that stress may reduce a woman's chance of becoming pregnant.  The study is the first of its kind to document, among women without a history of fertility problems, an association between high levels of a substance that is indicative of stress and a reduced chance of becoming pregnant.

The researchers showed that women who had higher levels of alpha-amylase were less likely to get pregnant than were women with lower levels of the substance.   Alpha-amylase is secreted into saliva by the parotid gland, the largest of the salivary glands.    Although alpha-amylase digests starch, in recent years it has been used as a barometer of the body's response to physical or psychological stress.  The substance is secreted when the nervous system produces catecholamines, compounds that initiate a type of stress response.

Researchers tracked the ovulation cycles of 274 English women ages 18-40 who were trying to conceive.  On the sixth day of their cycles, each woman collected a sample of her saliva, which was subsequently tested for alpha-amylase.  The researchers found that, all other factors being equal, women with high alpha-amylase levels were less likely to conceive than were women with low levels.  A larger study is currently underway to confirm these findings.  If these finding hold up, health providers will need to find appropriate ways to help women alleviate stress while trying to conceive.

To view the NIH Press release, click here.

State Coverage for Family Planning Services Updated
Posted by on January 29, 2010 - 11:45am

New information from the Kaiser Family Foundation and the George Washington University School of Public Health and Health Services on family planning services covered under Medicaid has been added and is available for 2009 for all states. The number of states that cover over-the-counter emergency contraception is 26; sterilization (36 +DC); Infertility testing (4); Infertility treatment (0); STD Testing  (11) and Treatment (9); HPV Vaccine for ages 21-26 (29). The report also contains information about family planning eligibility service waivers for each state. The map below demonstrates the emergency contraception coverage.

Coverage for Emergency Contraception

To view the entire report visit