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IVF success rates higher if egg collection is done in the summer, say researchers

New study suggests the best conditions for live births appear to be associated with summer

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The time of year when eggs are collected from women’s ovaries during fertility treatment could make a difference to live birth rates, new research has found.

Australian researchers have found that transferring frozen then thawed embryos to women’s wombs from eggs collected in the summer resulted in a 30 per cent higher likelihood of babies born alive than if the eggs had been retrieved in the autumn.

The team found a 28 per cent increase in the chances of a live birth among women who had eggs collected during days that had the most sunshine compared to days with the least sunshine.

“Over the duration of our study, the average live birth rate following frozen embryo transfer in Australia was 27 births per 100 people. In our study, the overall live birth rate following frozen embryo transfer was 28 births per 100 people,” said Dr Sebastian Leathersich, an obstetrician, gynaecologist and fellow in reproductive endocrinology and infertility at Fertility Specialists of Western Australia, City Fertility Centre, and the King Edward Memorial Hospital in Perth, Australia, who led the study.

“If eggs were collected in autumn, it was 26 births per 100 people, but if they were collected in summer there were 31 births per 100 people. This improvement in birth rates was seen regardless of when the embryos were finally transferred to the women’s wombs.

“The live birth rates when eggs were collected in spring or winter lay between these two figures, and the differences were not statistically significant.”

Until now, there have been conflicting findings on the effects of the seasons on pregnancies and live birth rates following egg collection and embryo freezing.

“It’s long been known that there is seasonal variation in natural birth rates around the world, but many factors could contribute to this including environmental, behavioural and sociological factors,” Leathersich explained.

“Most studies looking at IVF success rates have looked at fresh embryo transfers, where the embryo is put back within a week of the egg being collected. This makes it impossible to separate the potential impacts of environmental factors, such as season and hours of sunshine, on egg development and on embryo implantation and early pregnancy development.

“These days, many embryos are ‘frozen’ and then transferred at a later date. We realised this gave us an opportunity to explore the impact of environment on egg development and on early pregnancy separately by analysing the conditions at the time of egg collection independently from the conditions at the time of embryo transfer.”

Leathersich and his colleagues analysed outcomes from all frozen embryo transfers carried out at a single clinic in Perth over a period of eight years, from January 2013 to December 2021.

During this time there were 3,659 frozen embryo transfers with embryos generated from 2,155 IVF cycles in 1,835 patients. Information on outcomes was missing for two frozen embryo transfers and so these were excluded, leaving 3,657 for analysis.

The researchers looked at birth outcomes according to season, temperatures, and the actual number of hours of bright sunshine, as opposed to calculating hours from sunrise to sunset. They obtained the data on weather from the Australian Bureau of Meteorology. They created three groups for duration of sunshine on days when eggs were collected: low sunshine days, medium sunshine days and high sunshine days.

“When we looked specifically at the duration of sunshine around the time the eggs were collected, we saw a similar increase to that seen for egg collection during the summer,” Leathersich explained.

“The live birth rate following a frozen embryo transfer from an egg that was collected on a day with fewer hours of sunshine was 25.8 per cent.

“This increased to 30.4 per cent when the embryo came from an egg that was collected on days with the most hours of sunshine. When we took into account the season and conditions on the day of the embryo transfer, this improvement was still seen.”

The temperature on the day of egg collection did not affect the chances of a live birth. However, the chances of a live birth rate decreased by 18 per cent when the embryos were transferred on the hottest days compared to the coolest days and there was a small increase in miscarriage rates.

The study suggests that the best conditions for live births appear to be associated with summer and increased sunshine hours on the day of egg retrieval, Leathersich said.

“There are many factors that influence fertility treatment success, age being among the most important. However, this study adds further weight to the importance of environmental factors and their influence on egg quality and embryonic development,” he added.

“We effectively separated the conditions at the time of egg collection from the conditions at the time of transfer, demonstrating that environmental factors when the eggs are developing are as, if not more, important than environmental factors during implantation and early pregnancy.

“Optimising factors such as avoiding smoking, alcohol and other toxins and maintaining healthy activity levels and weight should be paramount. However, clinicians and patients could also consider external factors such as environmental conditions.”

Factors that may play a role in the increased live birth rates after egg collection in the summer and during more sunshine hours include melatonin. Levels of this hormone are usually higher in winter and spring, and eggs take three to six months to develop before they are released from the ovaries.

Differences in lifestyles between winter and summer months may also play a role, scientists say. The finding that miscarriage rates were highest when embryo transfer took place on the hottest days are consistent with epidemiological studies that show higher rates of miscarriage in the summer months.

“This suggests that the negative effects of high temperature are more likely related to early pregnancy rather than egg development,” said Dr Leathersich.

Limitations of the study include the fact that it is a retrospective rather than prospective study: looking back at what had already happened. For this reason, it can’t show that conditions at the time of egg collection cause the difference in live birth rates, only that they are associated with them.

“Ideally, these findings should be replicated in other sites with different conditions and different treatment protocols to confirm the findings,” Leathersich concluded.

“It would also be interesting to look at the impact of season and environmental factors on sperm parameters, as this could have contributed to our observations. We are now planning to analyse this same group of patients using air quality data, as there may be seasonal changes in exposure to harmful pollutants which could negatively affect reproductive outcomes.

“Finally, given the huge increase in so-called ‘social egg freezing’ for fertility preservation and the fact that this group generally have flexibility about when they choose to undergo treatment, it would be very interesting to see if these observations hold true with frozen eggs that are thawed and fertilised years later.

“Any improved outcomes in this group could have big impacts for women making decisions about their future fertility, but the long-term follow-up required means it is likely to be some time before we can draw any conclusions for this population.”

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Lawyers warn of discrimination risks around lack of menstrual health support in the workplace

Employers should consider proactively supporting women in managing menstruation at work, lawyers have argued

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Employers should consider the potential discrimination risks around menstrual health in the workplace, lawyers have warned, as research shows that most women in the UK feel unsupported.

According to the Chartered Institute of Personnel and Development (CIPD), the majority of women in the UK do not feel a strong sense of support in their organisation in relation to their menstrual cycle.

Figures show women are more likely to feel supported by colleagues than by their employer or manager, with only one in 10 reporting that their organisation provides support for menstruation and menstrual health.

Annisa Khan, employment lawyer at Farrer & Co who has previously raised the alarm over the lack of practical measures to support women with their periods, told Femtech World that employers should be mindful of the legal risks related to managing menstruation.

“Under the Equality Act 2010, it is unlawful to discriminate against employees based on sex, age, or disability,” she said.

“Employers should therefore consider the potential discrimination risks in relation to managing mensuration in the workplace and implement measures to reduce these risks.”

A lack of workplace period policies has been estimated to cost businesses over £6bn per year, as menstrual symptoms cause women to miss an average of 8.4 days per year due to lower productivity.

Khan said organisations should consider proactively supporting employees in managing menstruation at work by reviewing existing policies, including sickness absence and health and wellbeing policies, to ensure they effectively address menstrual-related concerns.

“Creating an open and supportive environment is crucial for employees to feel comfortable discussing periods at work,” she explained.

“This involves raising awareness among all staff, including senior-level managers and male colleagues, to foster an understanding of how colleagues may be affected by menstruation, the relevant policies and how to have open and empathetic conversations.

“Implementing practical measures is also essential to create a supportive environment. Practical steps can include having accessible bathroom facilities with sanitary bins, providing free period products to employees, offering additional breaks and providing a quiet space for rest.”

In line with CIPD’s findings, Khan said workplaces should also consider implementing more flexible working practices and giving women more breaks when needed.

“Employers should be open to employees adjusting their work pattern on the days they are experiencing menstruation symptoms by, for example, offering employees the opportunity to work from home.

“Additionally, they should consider the needs of employees with disabilities or those with medical conditions, and how they may be affected by managing mensuration at work.”

Heidi Watson, employment partner at Clyde & Co, said employers should ensure they avoid breaching discrimination laws when approaching issues like menstrual health.

“As awareness of menstrual issues such as endometriosis grows and as employees are more willing to discuss their symptoms at work, employers will need to consider whether employees are disabled under the legal definition and therefore entitled to protection from less favourable treatment and subject to the duty of the employer to make reasonable adjustments for them,” she told Femtech World.

“Employees may also be able to establish sex or age discrimination claims. We can expect more claims to come before the Employment Tribunal in the not too distant future, in a similar way as we have seen with cases involving menopause in recent years.

“Adopting a flexible approach to managing those with menstrual symptoms which are impacting their work, and creating an open and supportive culture around the issue, will help to reduce the risk of such claims being brought,” she added.

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OB/GYN-founded vitamin company pledges US$10m to improve women’s health research

Perelel aims to close the divide on women’s reproductive health research and improve access to nutritional support

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Alex Taylor and Victoria Thain Gioia, co-founders of Perelel

The US OB/GYN-founded vitamin company Perelel has pledged US$10m to Magee-Womens Research Institute and Good+ Foundation to fund women’s health research and address gaps in maternal healthcare.

The vitamin company said the US$10m would be distributed as both in-kind product donations and funding grants through 2027 focused on advancing women’s reproductive health.

Magee-Womens Research Institute is the largest US research foundation focused exclusively on women’s health, reproductive biology and infant research and care.

Good+Foundation is a national nonprofit working to dismantle multi-generational poverty by pairing tangible goods with innovative services for under-resourced individuals.

“As the only female OB/GYN-founded women’s vitamin company, Perelel is committed to ensuring that all women have access to medically backed care,” said Victoria Thain Gioia, co-founder and co-CEO of Perelel.

“This is why we are devoted to furthering women’s research in partnership with Magee-Womens Research Institute and creating more equity in the way underserved communities receive critical prenatal micronutrients that would otherwise be inaccessible thanks to Good+Foundation.”

Research shows that medical studies have historically excluded female participants and data have been collected from males and generalised to females.

The exclusion of women of “childbearing potential” from clinical research studies has meant that women’s diseases are often missed, misdiagnosed or remain a total mystery.

Alex Taylor, co-founder and co-CEO and of Perelel, said: “We recognise how wildly complex women’s bodies are — bodies that have historically been oversimplified, objectified and shamefully under-researched in medicine.

“Unfortunately, it’s not as simple as ’12 essential nutrients.’ In founding Perelel, we hope to shine a light on how dynamic our bodies are by supporting them with targeted solutions made by the doctors and experts who know best.

“Core to what we stand for is the need to keep fighting for our fundamental rights and help close the women’s health research gap and improve body literacy.”

Perelel’s pledge comes at a time of intensified focus on women’s health as efforts start to reach new levels, including the White House, after President Joe Biden announced the first-ever initiative on Women’s Health Research in 2023.

“It is critical that there is more in-depth medical research done to support women at every hormonal life stage,” said Michael Annichine, CEO at Magee-Womens Research Institute and Foundation.

“Perelel has committed to a cash donation to further advance research into women’s reproductive health and to ensure that this research is made more accessible to doctors everywhere.”

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New treatment could ‘disrupt’ growth of breast cancer tumours

A new type of immunotherapy could lead to pioneering treatment for breast cancer

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A breakthrough injection could “disrupt” the growth of breast cancer tumours, paving the way for a pioneering new treatment.

Breast cancer is the most common cancer in the UK with one woman diagnosed every 10 minutes. Around 55,000 women in the UK are diagnosed with breast cancer every year and 11,500 die from the disease each year.

Researchers from the Institute of Cancer Research have found that a new type of immunotherapy that targets non-cancer cells could help prevent the growth and spread of breast cancer tumours.

The discovery, published in The Journal for ImmunoTherapy of Cancer, has found that an immunotherapy approach targeting a protein, called endosialin, disrupts the tumour’s blood supply and, as a result, can hinder its growth and spread.

Unlike most cancer treatments, this innovative treatment does not target cancer cells directly but attacks the cells that support the disease instead.

Researchers used a type of immunotherapy called CAR-T therapy, which involves removing a patient’s healthy immune cells and genetically modifying them to attack specific targets.

CAR-T therapies are already being used to treat some blood cancers, and scientists are trying to find ways to make them effective for other types of cancer, including breast cancer.

However, CAR-T cell therapy does not always work on tumours because their environment suppresses the immune response, and it can also be challenging to find specific features on the breast cancer cells to target.

To work around these challenges, the team directed the CAR-T cells to cells surrounding the tumour’s blood supply that make the endosialin protein, rather than actual cancer cells. In experiments in mice, scientists found that targeting endosialin successfully reduced the breast cancer’s growth and spread.

The team, based at the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research (ICR), also tested the treatment on lung cancer tumours in mice and saw similarly successful results, suggesting patients with other types of cancer could benefit from this new treatment too.

In addition, researchers found that the CAR-T therapy did not affect cells without endosialin, indicating this could work as a cancer-specific treatment with potentially fewer side effects for patients.

“This is the very first study that demonstrates the effectiveness of using endosialin-directed CAR-T cells to reduce breast cancer tumour growth and spread,” said Dr Frances Turrell, study co-leader and postdoctoral training fellow in the division of breast cancer research at the Institute of Cancer Research.

“Immunotherapy has had limited success in treating breast cancer but by targeting the cells that support the tumour and help it to survive, rather than the cancer cells directly, we’ve found a promising way to overcome the challenges posed by the tumour environment and develop a more effective and targeted treatment for breast cancer.

“We could not have done this project without funding to the Molecular Cell Biology group from Breast Cancer Now and we hope that further research will help translate these findings into targeted therapies for breast cancer patients.”

Dr Simon Vincent, director of research, support and influencing at Breast Cancer Now, said: “This exciting research could lead to much-needed targeted treatments for people with breast cancer, and with one person dying from breast cancer every 45 minutes in the UK, new treatments like these are urgently needed.

“Now we know that the treatment works in principle in mice, Breast Cancer Now researchers can continue to develop this immunotherapy to make it suitable for people, as well as to understand the full effect it could have and who it may benefit the most.”

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