It is quite common for both OBGYN and Fertility doctors to encourage their patients who have had multiple miscarriages take baby aspirin in order to reduce the risk of future pregnancy losses. The problem with this is that these recommendations were never really backed up by research to see if aspirin is really effective in preventing miscarriages. In order to determine if this common practice was effective, the NIH conducted a large trial to see if taking daily baby aspirin would reduce the risk of subsequent miscarriage in women with 1 or 2 prior miscarriages. Unfortunately, as reported in the journal Lancet, baby aspirin did not help and these women were no more likely to experience another pregnancy loss than those who took a placebo. The one bright spot in this study: women who took had a single loss early in pregnancy within the last year and took baby aspirin were more likely to actually become pregnant.
There has been a lot of chatter about effects of BPA in the news, an additive in plastics bottles and their effects on reproduction. The NIH decided to look into plastics additives effects on female and male fertility, and they found something interesting. Men who were exposed to pthalates, additives used to softer plastics such as vinyl took longer for their partners to conceive than those who did not; 20% longer. Surprisingly, BPA exposure in either partner and phthalate exposure in women did not affect fertility. While this does not prove that these chemicals cause infertility in men, it is another piece in the unsolved puzzle about how that environment may be affecting our reproductive health.
It has been known for some time that couples suffering from infertility, including those who get pregnant using assisted reproductive techniques such as IVF, are more likely to have complicated pregnancies.: more high blood pressure, diabetes, miscarriages, preterm births and likely birth defects as well. This is true even with singleton pregnancies. What is not so clear is why this is so. Is it the patient population? Women who have infertility tend to be older and have more medical and metabolic problems. Is it the fertility medications such as clomid and injectables? Is it something in the process of IVF or IUI that causes problems? Researchers at Cedars Sinai Hospital in Los Angeles have received a large grant from the National Institute of Child Health and Development to help study the molecular events the underlie an early pregnancy after IVF. They will be looking at both genetics (the DNA in the chromosomes) and epigenetics (changes in gene expression that occur outside the chromosomes) to try to discover an explanation for these problems
The Endocrine Society has issued new guidelines for the diagnosis of Polycystic Ovarian Syndrome (PCOS). These guidelines developed by a special task force are based in part on the Rotterdam criteria and were recently published in the Journal of Clinical Endocrinology and Metabolism. Women are diagnosed with PCOS when they have 2 out of the 3 following conditions:
- Problems with ovulation such as irregular cycles
- Excess levels of male hormone levels on bloodwork or based on symptoms such as abnormal hair growth or loss, acne
- Large numbers of ovarian follicles or "cysts" on ultrasound
Additionally, doctors will need to rule other hormonal disorders that may mimic PCOS and are advised to screen for medical diseases such as diabetes and hypertension that are more common in women with PCOS. They also issued recommendations for treatment of infertility and irregular cycles in PCOS patients.