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Birth control pills may affect the body’s ability to regulate stress, say researchers

Scientists measured the stress hormone ACTH, making it possible to observe and analyse rapid changes in a woman’s stress response

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Contraceptive pills may have an impact on the body’s ability to regulate stress, a new study has found.

Researchers from Aarhus University and the United States have studied the stress response of 131 young women by measuring the levels of the stress hormone ACTH in the their blood. Some of the participants were on birth control, while others were not.

The study showed that 15 minutes of social activity after having a blood sample taken lowered stress hormone levels in women who were not on birth control. In contrast, women on birth control did not experience any reduction in their ACTH levels.

To avoid causing any additional stress to the test subjects, a small intravenous catheter was inserted in connection with the first blood sample. The researchers could then draw blood after the social activity without having to prick the women with a needle again.

After having a blood sample taken, they could then participate in one of six different group activities such as playing board games, getting to know each other in a group session, singing songs together or attending a church service.

“Being with other people is one of the most effective ways of reducing stress,” explained Michael Winterdahl, a visiting scholar at the translational neuropsychiatry unit at the department of clinical medicine.

“Our results are important because they indicate that people who use birth control pills do not experience the same reduced stress hormone levels in connection with social activity as people who don’t.”

It has long been established that birth control pills affect the stress response in women. However, looking at the stress hormone ACTH in connection with a social activity is a new approach.

The research differs from previous studies that have primarily focused on the stress hormone cortisol in extreme circumstances.

In this study, scientists measured the stress hormone ACTH, which changes significantly faster than cortisol, making it possible to observe and analyse rapid changes in a person’s stress response.

“By studying ACTH levels, we take another step towards understanding how the brain regulates stress as ACTH acts as a neurotransmitter from the brain to the adrenal cortex, which produces cortisol,” said Winterdahl.

“When we analyse ACTH levels, we can gain insight into the quick-response mechanism that controls the body’s reaction to stress.”

Birth control pills are known for being able to affect the hypothalamic-pituitary-adrenal (HPA) axis. As the name indicates, the stress signal travels from the hypothalamus in the brain through the pituitary gland that releases ACTH to the adrenal glands that release cortisol.

However, researchers still need an explanation to why women on birth control do not experience the same reduction of stress hormone levels in connection with social activities as those who are not on the pill.

Winterdahl said there are several competing hypotheses that try to explain the lower cortisol levels in women on birth control.

“Our research has pushed us closer to an explanation that centres on the brain and the ACTH dynamics. The biochemistry is complex, but we are working based on the assumption that birth control pills can suppress the body’s own production of progesterone.”

The study additionally revealed that the stress response in women who did not take birth control pills depended on where they were at in their menstrual cycle.

The stress-reducing group activities had no effect on the ACTH levels of the women who were in the proliferative phase of their cycle – just after their period has ended and the body begins producing hormones to get ovulation started.

“Progesterone levels are very low during the proliferative phase of a natural cycle. This leads to a minimal conversion of progesterone into the hormone allopregnanolone,” said Winterdahl.

“Since allopregnanolone is important for activating the receptors that regulate the stress response, we don’t see a reduction in ACTH levels in women with a natural cycle who have just had their period.”

He pointed out that women also tend to be more physically active during the proliferative phase which could be seen as an adaption in which the stress response and behaviour change in step with the cycle.

In women on birth control, he said, the stress response is “disconnected”, meaning it can not be adapted to a given situation.

Research still can’t explain exactly how this affects women. Additional studies are needed to clarify the complex mechanisms involved in the correlation between hormone levels and the stress response.

“There are different generations of the pill, each with its own chemical structure due to the hormones used, which means the pills have different side-effect profiles,” Winterdahl concluded.

“It’s therefore crucial that our experiments are reproduced with a larger and more diverse group of test subjects.”

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‘Long waiting lists and patchy care provision’- NHS-funded IVF cycles fall to 14-year low

NHS-funded IVF procedures dropped to 27 per cent in 2022 from 40 per cent in 2012, new data shows

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The proportion of NHS-funded IVF cycles in the UK has fallen to the lowest level for 14 years, leaving fertility patients either unable to access treatment or forced to go private.

Some 27 per cent of IVF cycles were funded by the NHS in 2022, the lowest figure since 2008 and a sharp fall on the 40 per cent which it provided in 2012, according to the latest annual report by the Human Fertilisation and Embryology Authority (HFEA).

The number of NHS-funded cycles of IVF fell by 17 per cent in England, 16 per cent in Wales and seven per cent in Scotland between 2019 and 2022, the report showed. The East Midlands of England saw the biggest fall during that time, down 48 per cent.

The regulator said the fall may be being fuelled by the rise in NHS waiting lists, meaning it is taking longer for many patients to see a specialist in the first place.

Such delays can mean that women seeking help with fertility lose their window for treatment, as the chances of success fall.

Julia Chain, chair of the HFEA, said: “Our data shows the average age of patients starting treatment for the first time is now nearly six years older than the average age at which women in England and Wales gave birth to their first child.

“There are several possible factors for this including the knock-on effect of delays across the NHS due to the COVID-19 pandemic, particularly in gynaecology, which has likely led to delays in some patients accessing fertility services.”

The higher average age, Chain said, may also relate to difficulty in funding fertility treatment, owing to recent increases in the cost of living, a fall in the proportion of NHS-funded IVF cycles and increased waiting times for further investigations before accessing NHS-funded treatment.

Leila Thabet, general manager at Maven Clinic, told Femtech World: “Today’s figures highlight what many of us working in the field of women’s health have known for some time – fertility treatment is extremely challenging to access on the NHS.

“NHS IVF treatment is subject to long waiting lists and patchy care provision, often with inadequate support for the emotional toll the treatment takes.

“Women undergoing IVF will all need different types and levels of support as every IVF journey is different. This personalised treatment is not something the NHS is set up to provide, so even where women are lucky enough to benefit from NHS fertility treatment, they may need to turn to other providers for additional physical and emotional support.”

She added: “Women going through IVF often describe it as all consuming. It impacts every aspect of your life – physically, emotionally and practically. Juggling IVF treatment and a career are notoriously hard, for example. Add the huge financial toll, and we can clearly see why fertility treatment is life changing in every sense, no matter the outcome.”

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Future Fertility and IVI RMA Global Research Alliance forge landmark commercial partnership to raise standard of care in egg quality assessment

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Future Fertility, the leader in AI-powered oocyte quality assessment, and IVI RMA Global, the world’s leading reproductive medicine group, are excited to announce their new strategic commercial partnership.

Under this landmark agreement, Future Fertility’s VIOLET™ tool will be integrated into every egg freezing cycle at IVI RMA’s clinics across Europe and Latin America. Both companies will also collaborate to determine how this technology can be used to assess donor egg quality to provide greater transparency and precision in egg donation treatments.

IVI RMA is renowned for its scientific leadership and adoption of cutting-edge technology to advance patient care. This collaboration marks IVI RMA’s first large-scale AI technology partnership and is the most extensive clinic network partnership to date for Future Fertility.

Future Fertility has rapidly gained adoption within the fertility industry, with its oocyte assessment tools installed in over 100 clinics across more than 25 countries. Its seamless integration with various laboratory setups, from time-lapse to microscope-only environments, and unparalleled patient-facing oocyte quality reports have been the drivers of this momentum.

As the company’s dataset has grown to over 150,000 oocyte images and associated reproductive outcomes, the adoption of these tools is driving the creation of a standard of care for oocyte quality assessment.

“Future Fertility’s AI tools allow our clinics to evaluate oocyte quality with an unprecedented level of objectivity and data-driven precision,” said Prof. Laura Rienzi, head of innovation at IVI RMA.

“Their dedication to thorough clinical validation and peer-reviewed scientific publications provides us with evidence that these tools hold the potential to improve our lab processes, treatment planning and patient experience across our network.”

“Partnering with IVI RMA is an incredibly exciting milestone for us,” said Christy Prada, CEO of Future Fertility.

“This is a true testament to the value of our oocyte reports from an extremely prestigious leader in clinical care, and a strong validation of our scientific approach from the largest clinical network in fertility care globally.”

Empowering egg freezing patients with personalised insights

Historically, fertility specialists estimated an egg freezing patient’s chance of success based on age and the number of mature eggs retrieved.

Future Fertility’s deep learning model personalises fertility care by evaluating each egg’s unique likelihood of developing into a blastocyst based on its image. VIOLET™ reports also provide each patient with their personal chance of achieving a live birth from the eggs they’ve frozen.

Dr Antonio Requena, IVI RMA’s group medical director, emphasised the impact on patient care: “These individualised insights allow our clinical team to customise treatment plans to each patient’s specific needs, offering essential clarity on treatment expectations and improving patient counselling for future steps.”

“The current standard of care in reproductive medicine includes standardised methods to evaluate sperm, embryos, and the endometrium – but not the egg,” says Dr Dan Nayot, chief medical officer and co-founder at Future Fertility.

“Our team has been able to address this gap with AI so that patients and their fertility care teams can be empowered with precise information to make more-informed decisions along the path to parenthood.”

Long-term scientific partnership and expanded commercial collaboration

IVI RMA, ever committed to the scientific advancement of reproductive medicine, first began utilising Future Fertility’s tools in egg quality-focused research at its leading clinics in Spain in 2022.

Dr Marcos Meseguer, scientific director at IVI Valencia, highlighted the benefits of these tools in driving new avenues for investigation: “Future Fertility’s oocyte AI has created the opportunity for us to study and better understand the impact of different clinical approaches on egg quality.

“As the first player to develop this type of solution, they are paving the way for the industry to evolve thinking on the role of egg quality in treatment plans.”

His team presented their scientific findings at last year’s American Society of Reproductive Medicine conference in New Orleans, confirming the ability of VIOLET™ to predict fertilisation, blastocyst and live birth outcomes from oocyte images taken within the lab.

Other IVI RMA clinics under the GINEFIV, GINEMED and GENERA brands have been using VIOLET™ and MAGENTA™ in their scientific research for the past year and a half, assessing the role of AI in evaluating donor egg quality, enhancing transparency for recipients, and optimising donor egg screening.

“We were early believers in the importance of oocyte quality with respect to reproductive success,” said Dr Danilo Cimadomo, director of innovation in embryology at IVI RMA Italia.

“Future Fertility’s AI tools hold potential for improving our research projects by bringing objectivity into our efforts to better understand egg donor cycles.”

The progression of this enduring partnership from experimental roots to commercial adoption is indicative of the growing affirmation of Future Fertility’s technology worldwide.

Rafael Gonzalez, head of global sales and commercial strategy at Future Fertility, commented: “Our commercial traction has been remarkable across the countries we operate in.

“This new partnership with IVI RMA Global is the culmination of our long-time collaboration and is now empowering patients globally with more precise insights into their fertility treatment options.”

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Women with endometriosis face fourfold higher risk of ovarian cancer, study finds

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The risk of developing ovarian cancer could jump about fourfold among women with endometriosis compared with women without the condition, a new study has found.

A landmark study from researchers at the University of Utah and Boston University Chobanian & Avedisian School of Medicine found that women with severe endometriosis are 10 times more likely to get ovarian cancer compared to women who do not have the disease.

Prior studies have shown a causal connection between endometriosis and ovarian cancer but in using the Utah Population Database, a repository of linked health records housed at Huntsman Cancer Institute at the University of Utah, investigators were able to analyse the incidence rates of different types of endometriosis and subtypes of ovarian cancer for the first time.

Their research, which included a cohort of over 78,000 women with endometriosis, found that women with severe forms — either deep infiltrating endometriosis, ovarian endometriomas or both — have an overall ovarian cancer risk that’s “markedly increased,” at about 9.7 times higher, relative to women without endometriosis.

Women with deep infiltrating endometriosis, ovarian endometriomas or both, on the other hand, appear to face nearly 19 times the risk of type I ovarian cancer, which tends to grow more slowly, compared with women without endometriosis, according to the study.

In their calculations, researchers also found that women with any kind of endometriosis have a 4.2-fold risk of developing ovarian cancer compared to those who do not.

“These are really important findings,” said Jennifer Doherty, investigator and professor of the population health sciences department at the University of Utah.

“This impacts clinical care for individuals with severe endometriosis, since they would benefit from counselling about ovarian cancer risk and prevention.

“This research will also lead to further studies to understand the mechanisms through which specific types of endometriosis cause different types of ovarian cancer.”

However, women with endometriosis should not panic about the findings, researchers noted, because ovarian cancer itself is still rare. About 1.1 per cent of US women will be diagnosed with ovarian cancer at some point in their lifetime, according to the National Cancer Institute.

“Because of the rarity of ovarian cancer, the association with endometriosis only increased the number of cancer cases by 10 to 20 per 10,000 women,” Karen Schliep, senior author of the study and an associate professor in the Division of Public Health at the University of Utah School of Medicine, told CNN.

“We would not recommend, at this point, any change in clinical care or policy. The best way of preventing ovarian cancer is still the recommendation of exercise, not smoking and limiting alcohol.”

Women with endometriosis could pursue surgeries, such as hysterectomies or removal of the ovaries, investigators said. However, since these are invasive procedures, more research is needed to know if these are the right measures, they concluded.

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