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Research roundup: AI models independently interpret mammograms, and more

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Femtech World explores the latest research and science developments in the world of women’s health.

AI models independently interpret mammograms

AI models have shown excellent performance for detecting breast cancers on mammography images.

The algorithms, submitted for a 2023 AI Challenge hosted by the Radiological Society of North America (RSNA), demonstrated increased screening sensitivity while maintaining low recall rates, according to a new study.

The goal of the Challenge was to source AI models that improve the automation of cancer detection in screening mammograms, helping radiologists work more efficiently, improving the quality and safety of patient care, and potentially reducing costs and unnecessary medical procedures.

A research team evaluated 1,537 working algorithms submitted to the Challenge, testing them on a set of 10,830 single-breast exams – completely separate from the training dataset – that were confirmed by pathology results as positive or negative for cancer.

The algorithms yielded median rates of 98.7 per cent specificity for confirming no cancer was present on mammography images, 27.6 per cent sensitivity for positively identifying cancer, and a recall rate, the percentage of the cases that AI judged positive, of 1.7 per cenr.

When the researchers combined the top three and top 10 performing algorithms, it boosted sensitivity to 60.7 per cent and 67.8 per cent, respectively.

According to the researchers, creating an ensemble of the 10 best-performing algorithms produced performance that is close to that of an average screening radiologist in Europe or Australia.

Individual algorithms showed significant differences in performance depending on factors such as the type of cancer, the manufacturer of the imaging equipment and the clinical site where the images were acquired.

Overall, the algorithms had greater sensitivity for detecting invasive cancers than for noninvasive cancers.

Since many of the participants’ AI models are open source, the results of the Challenge may contribute to the further improvement of both experimental and commercial AI tools for mammography, with the goal of improving breast cancer outcomes worldwide.

The research team plans to conduct follow-up studies to benchmark the performance of the top Challenge algorithms against commercially available products using a larger and more diverse dataset.

Cracking the cold case of endometriosis with big data

Records from millions of patients at UC health centers found correlations between endometriosis, one of the most common diseases in women, and a bounty of other diseases.

Scientists at UCSF have found that endometriosis often occurs alongside conditions like cancer, Crohn’s disease, and migraine.

The research could improve how endometriosis is diagnosed and, ultimately, how it is treated; and it paints the sharpest portrait yet of a condition that is as mysterious as it is prevalent.

The study used computational methods developed at UCSF to analyse anonymised patient records collected at the University of California’s six health centers.

Using algorithms developed for the task, researchers hunted for connections linking endometriosis with the rest of each patient’s health history.

Endometriosis patients were compared with patients who did not have it, and categorised the patients with endo into groups based on shared health histories.

The findings from the UCSF data were mapped against the rest of the UC’s health data to see if they held up across California.

The team say they found over 600 correlations between endometriosis and other conditions, ranging from infertility, autoimmune disease, and acid-reflux, to cancers, asthma, and eye-related diseases.

Some patients had migraines, bolstering previous studies suggesting that migraine drugs might help treat endometriosis.

The study supports the growing understanding of endometriosis as a “multi-system” disorder – a disease arising from dysfunction throughout the body.

Respiratory viruses can wake up breast cancer cells in lungs

Researchers have found the first direct evidence that common respiratory infections, including Covid-19 and influenza, can awaken dormant breast cancer cells that have spread to the lungs, setting the stage for new metastatic tumours.

The findings, obtained in mice, were supported by research showing increases in death and in metastatic lung disease among cancer survivors infected with SARS-CoV-2, the virus that causes Covid-19.

“Our findings indicate that individuals with a history of cancer may benefit from taking precautions against respiratory viruses, such as vaccination when available, and discussing any concerns with their healthcare providers,” said Julio Aguirre-Ghiso, a co-leader of the study and director of MECCC’s Cancer Dormancy Institute.

Prior to the study, some evidence suggested that inflammatory processes can awaken disseminated cancer cells (DCCs) – cells that have broken away from a primary tumor and spread to distant organs, often lying dormant for extended periods.

“During the COVID-19 pandemic, anecdotal reports suggested a possible increase in cancer death rates, bolstering the idea that severe inflammation might contribute to arousing dormant DCCs,” said Dr. Aguirre-Ghiso, who also serves as leader of MECCC’s Tumor Microenvironment and Metastasis Research Programme.

Researchers tested this hypothesis using Dr. Aguirre-Ghiso’s laboratory’s unique mouse models of metastatic breast cancer, which include dormant DCCs in the lungs and therefore closely resemble a key feature of the disease in humans.

The researchers exposed mice to SARS-CoV-2 or influenza virus. In both cases, the respiratory infections triggered the awakening of dormant DCCs in the lungs, leading to a massive expansion of metastatic cells within days of infection and the appearance of metastatic lesions within two weeks.

Molecular analyses revealed that the awakening of dormant DCCs is driven by interleukin-6 (IL-6), a protein that immune cells release in response to infections or injuries.

The Covid-19 pandemic offered a unique opportunity to investigate the effect of respiratory virus infections, in this case from the SARS-CoV-2 virus, on cancer progression.

The research team analysed two large databases and found support for their hypothesis that respiratory infections in cancer patients in remission are linked to cancer metastasis.

The UK Biobank is a general population cohort in which some of the more than 500,000 participants were diagnosed with cancer and other diseases prior to the Covid-19 pandemic.

Researchers from Utrecht University and Imperial College London investigated whether a Covid-19 infection increased the risk of cancer-related mortality among participants with cancer.

They focused on cancer survivors who had been diagnosed at least five years before the pandemic, ensuring they were likely in remission.

Among them, 487 individuals tested positive for COVID-19 and these were compared to 4,350 matched controls who tested negative.

After excluding those cancer patients who died from Covid-19, the researchers found that cancer patients who tested positive for Covid-19 faced an almost doubling of risk of dying from cancer compared to those patients with cancer who had tested negative.

From the second population study, the U.S. Flatiron Health database, researchers drew data pertaining to female breast cancer patients seen at 280 U.S. cancer clinics.

They compared the incidence of metastases to the lung among Covid-19-negative patients and Covid-19-positive patients (36,216 and 532 patients respectively).

During the follow-up period of approximately 52 months, those patients who came down with Covid-19 were almost 50 per cent more likely to experience metastatic progression to the lungs compared with patients with breast cancer without a diagnosis of Covid-19.

“Our findings suggest that cancer survivors may be at increased risk of metastatic relapse after common respiratory viral infections,” said Dr. Vermeulen.

Losing weight before IVF may increase chance of pregnancy

A systematic review and meta-analysis of randomised controlled trials (RCTs) has assessed whether weight loss interventions before in vitro fertilization (IVF) improved reproductive outcomes.

The review found that weight loss interventions before IVF could increase the chances of pregnancy, especially in unassisted conception, although the effect on live births was unclear.

The findings are published in Annals of Internal Medicine.

Researchers from the University of Oxford reviewed 12 RCTs comprising 1,921 patients conducted between 1980 through 27 of May 2025.

Inclusion criteria included studies conducted on women at least 18 years old with a BMI of 27 kg/m2 or greater who were seeking IVF with or without intracytoplasmic sperm injection treatment for infertility.

Outcomes of interest were the number of participants achieving pregnancy without IVF (unassisted pregnancy), with IVF (treatment-induced pregnancy), overall (unassisted plus treatment-induced) and those delivering a live infant.

The researchers found that participants were typically women in their early 30s with a median baseline BMI of 33.6 kg/m2.

Weight loss interventions studied included low-energy diets, an exercise program accompanied by healthy eating advice, and pharmacotherapy accompanied by diet and physical activity advice.

Overall, weight loss interventions before IVF were associated with greater unassisted pregnancy rates. Evidence was inconclusive on the effect of weight loss interventions on treatment-induced pregnancies.

Evidence on the association between weight loss interventions before IVF and live births was uncertain, although there was moderate certainty of no association with pregnancy loss.

The findings suggest that weight loss interventions before IVF increase total pregnancies, mainly through an increase in unassisted pregnancy rates.

However, further high-quality clinical trials testing different weight loss interventions, particularly those known to achieve greatest weight losses, such as low-energy total diet replacement programmes, are needed.

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UK reviews surrogacy firm over rejected insurance claims

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The UK government is reviewing a surrogacy firm after complaints that medical insurance claims involving surrogates in Mexico were rejected.

The Department of Health and Social Care (DHSC) is considering whether UK-based provider My Surrogacy Journey should remain listed on gov.uk as one of four domestic surrogacy agencies available to intended parents.

The review follows allegations concerning its Mexican sister company, where surrogates are based.

Health minister Diana Johnson said: “The department is looking into the allegations about My Surrogacy Journey.

“As part of that assessment, the department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.”

Emails sent by My Surrogacy Journey chief executive Michael Johnson-Ellis and seen by the Guardian suggest multiple surrogate women in Mexico had their insurance claims rejected.

The emails also suggest 300 couples using the company were moved to a new insurance provider because of the increased risk of claims being rejected.

Commercial surrogacy is banned in the UK, where only altruistic arrangements are permitted.

My Surrogacy Journey operates a not-for-profit UK branch alongside for-profit sister companies in Mexico and the US. All three companies have the same owners and chief executives.

The reported insurance issues relate to surrogacy arrangements in Mexico.

One couple told the Guardian they paid tens of thousands of pounds to cover medical costs after their surrogate had a hysterectomy during childbirth and an insurance claim was refused.

The Guardian said it understood that at least five sets of parents said they had to cover medical costs after insurance claims were rejected.

In an email to the couple whose surrogate underwent a hysterectomy, Johnson-Ellis wrote: “We have already told you that the insurance companies have been declining some of the claims and we are actively working with the broker to get this issue resolved but you should also consider that they may not be paid out and there is nothing we are able to do to change this …

“We appreciate this is not an insignificant sum but this genuinely is out of our control.”

Johnson-Ellis also said the company had switched insurance providers, writing: “We’re also managing this for 300 other journeys, which is a complex position to be in.”

Lawyers acting for My Surrogacy Journey said the company did not comment on individual cases, but that existing insurance policies were in place and claims continued to be accepted and processed.

They said the company understood that a small number of claims had been rejected and was supporting people seeking to resolve those claims with an insurer.

Under the surrogacy arrangements, intended parents are understood to be contractually required to cover medical costs not paid by an insurer.

The couple said they had been recommended the company’s Mexico option. Its website advertises that intended parents using the route can have a baby in “under 18 months”.

They said they were told the UK route could take up to five years and that the US option was much more expensive.

Lawyers for My Surrogacy Journey said prospective parents are given information about typical timelines, costs, legal frameworks and practical considerations, and that the 18-month timeframe is indicative only.

The couple said their surrogate developed placenta accreta, a serious condition in which the placenta attaches to the wall of the uterus.

Emails from Johnson-Ellis acknowledged that the insurance provider investigated the birth after the surrogate experienced health complications.

The parents are considering legal action, while the Guardian said it understood at least four other couples were reviewing their options.

Phil Brickell, MP for Bolton West, raised concerns in parliament about a separate couple who had used My Surrogacy Journey.

He said: “Two of my constituents recently travelled to Mexico, where their children were born by surrogacy.

“Those births were facilitated by a company called My Surrogacy Journey, which is listed on gov.uk.

“While in Mexico, they had repeated traumatic experiences with the company relating to issues including insurance for their children, accusations of bullying towards staff and repeated efforts to silence any constructive criticism.

“I understand that other members of this house have received similar complaints.”

Brickell called for My Surrogacy Journey to be removed from gov.uk pending a review by the Human Fertilisation and Embryology Authority.

Lawyers acting for My Surrogacy Journey said the company was communicating with DHSC and was confident any issues could be resolved.

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‘Limited scientific evidence’ for most menopause supplements, expert says

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Many menopause supplements contain ingredients with limited evidence for symptom relief, while formulations and prices vary widely, a study has found.

Researchers analysed 201 products sold by nine major UK retailers, comparing their ingredients, doses and monthly costs.

Prices ranged from £1.50 to £95 a month, while no single ingredient or category of ingredient was common across all products.

The study, carried out by University College London, found that 80 per cent of products contained herbs, 77 per cent contained vitamins and 74 per cent contained phytoestrogens, naturally occurring plant compounds found in foods including soy and flaxseed.

Vitamin B6 was the most common vitamin, while red clover and sage were the most frequently identified plant ingredients.

Researchers said more evidence was needed on the effectiveness and safety of supplements marketed for menopause symptoms.

Professor Joyce Harper, senior author of the study and professor of reproductive science at University College London, said: “The menopause supplement market is growing rapidly, despite limited scientific evidence that many of these products improve menopause symptoms.

“Some social media influencers promote these products as effective solutions, despite many claims not being supported by scientific evidence.

“This can contribute to the spread of misinformation and help drive a rapidly growing menopause supplement market, leading some women to spend substantial amounts of money on supplements in the hope of improving their symptoms and overall wellbeing.”

Half of the supplements did not contain vitamin D, while less than 24 per cent contained calcium.

The British Menopause Society and International Menopause Society have highlighted vitamin D and calcium as important for maintaining bone health and preventing osteoporosis after menopause.

Researchers also identified botanical ingredients that may carry risks, including black cohosh.

Poppy Sullivan, first author of the study, said: “Certain botanical ingredients in some menopause supplements may also have risks.

“Black cohosh, in particular, is known to carry a potential risk of liver toxicity.”

The amounts of vitamins and minerals included in different products also varied widely.

Sullivan said: “Some nutrients can have adverse effects when consumed in excess over time.

“For example, excessive vitamin D intake can theoretically lead to high calcium levels, which could cause adverse effects such as vomiting and confusion.”

The study found little empirical evidence supporting the effectiveness of even the most expensive products.

Researchers called for more high-quality research, including clinical trials, to determine whether menopause supplement ingredients are effective and safe.

They said the findings could also help healthcare professionals understand the wide variation in supplement formulations.

The researchers acknowledged that the analysis may not have included every menopause supplement available in the UK.

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Ultrasound Direct extends Trice Imaging partnership

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Ultrasound Direct has extended its Trice Imaging partnership for three years, adding a reporting tool across its 70-clinic UK network.

The private ultrasound provider will continue using the Tricefy platform for secure image storage and patient engagement, alongside TriceIQ for efficiency and productivity analytics.

It will also introduce Trice Workspace Reporting across its network. The companies say the tool will help standardise ultrasound reporting templates and workflows and reduce variation between clinics.

Ultrasound Direct carries out an estimated 120,000 patient scans each year across services including pregnancy, fertility, women’s health, men’s health and other diagnostic pathways.

Its network uses a large pool of sonographers working across different ultrasound systems and serves referral routes including self-referring patients, GPs and commercial partners.

Mike Steward, founding director at Ultrasound Direct, said: “Having worked with Trice Imaging since 2018, we first partnered to replace manual methods of providing scan images to expectant parents with Trice’s secure electronic image-sharing platform. Today, every study performed across the Ultrasound Direct Network is recorded and stored on Tricefy, while our clinical services have expanded considerably beyond pregnancy into fertility, women’s health, men’s health and other diagnostic pathways.”

He added: “To continue futureproofing our image management strategy across a network of 70 clinics, a large team of sonographers, varying ultrasound systems and a growing number of referral partners with different needs, we decided to extend with Trice Imaging. This includes the introduction of the new Trice Workspace Reporting module to help us scale and standardise our ultrasound reporting templates and workflow, reducing variability between clinics.”

The partnership began in 2018, initially focusing on replacing manual methods of sharing pregnancy scan images with expectant parents.

Johanna Wollert Melin, founder and chief executive of Trice Imaging Europe, said: “Ultrasound Direct has been a valued partner in the UK for 8 years.”

She added: “At the heart of the relationship is a willingness to explore new ideas, test new tools and the spirit to solve real challenges across a large and complex clinical network.”

Mark A. Samii, chief revenue officer at Trice Imaging, said: “We are delighted to retain and extend our relationship with Ultrasound Direct.”

He added: “The addition of Trice Workspace Reporting addresses a challenge we hear from multi-site providers globally – keeping reporting quality consistent across many users, systems, referral or payer relationships.”

Steward said Ultrasound Direct continues to see growing demand for private diagnostics alongside NHS care from self-referring patients and an increasingly diverse range of professional and commercial referral partners.

He added: “As that development continues, scalable digital infrastructure becomes increasingly important. Our focus is on ensuring that a growing national network can support consistent clinical workflows, different referral pathways and the technology requirements of the future, while continuing to provide patients with accessible diagnostic services.”

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