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UK medical team to lead study into access to cervical screening after birth

Current UK guidance suggests women should wait for 12 weeks after they have given birth to be screened

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A team of UK gynaecological oncology doctors have been awarded £300,000 to run a research study aimed at improving the uptake of cervical cancer screening among women who have recently given birth.

The team, based at the Somerset NHS Foundation Trust, will get people’s views on how to improve the take up on cervical screening and access to services.

While cervical screening is safe during pregnancy and may be needed, it is often delayed until afterwards, particularly if a woman’s screening was up-to-date and normal prior to pregnancy.

Current guidance from the national screening programme suggests women should wait for 12 weeks after they have given birth to be screened.

But women and GP practices told Dr Jo Morrison, consultant gynaecological oncologist at the NHS trust, and Dr Holly Baker-Rand and Dr Becky Newhouse, both specialty registrars and clinical fellows, that it may be easier to get this done at their regular six-week post-birth appointment. This would avoid coming back for a second appointment when women are busy and have other priorities.

It is not the first time the Somerset NHS Foundation Trust has been involved in cervical screening research with Morrison and former Musgrove postgraduate doctor, Dr Sarah Coleridge, winning a national Jo’s Cervical Cancer Trust Innovation Award for a project to improve the take up on cervical screening in young women who’d just had a baby.

One of the ideas that was generated on the back of Dr Coleridge’s project, largely from the women she spoke to, was that they would prefer to have had a postnatal follow-up smear at their six-week GP check-up.

“Current guidance says that a cervical smear test can only be done 12 weeks after a woman has given birth,” Dr Morrison explained.

“But we’ve listened to the feedback from women and investigated why the recommendation is to delay to 12 weeks.

“We found that it was based on just one very old study, involving only a few people, at a time when smear testing wasn’t as advanced as it is today, and before we tested for HPV.

“So we wanted to carry out research based on the idea that new mums might find it easier to get their screening done at that one appointment, rather than having to make another appointment six weeks later – much easier for our GP practices and the patients themselves, who would be less likely to miss it.

“Before we begin the ‘Postnatal Instead of Normally-timed Cervical Screening’ study  – or PINCS for short – we are running a study to check women’s view to make sure that this is absolutely something that women would want us to look into.

“If our study shows no difference in the quality of testing at six rather than 12 weeks, this could be offered to women earlier. Obviously, those who aren’t ready by six weeks would be free to delay the test.”

Morrison said her team would check the acceptability of testing with a urine test, rather than a normal smear test, and whether this is something that women might find easier.

“We’re calling this first part of the study, ‘Pre-PINCS’, where we’re testing what women think about the idea, and whether they would be willing to have a smear done six weeks after giving birth. If the reaction is positive, then we hope to get a full clinical study up and running,” she added.

“Pre-PINCS has involved a questionnaire given to women who’ve given birth within the past five years. We will also offer conversations with a few women who have given birth recently or are currently pregnant, to find out in more depth about their views on cervical screening in general, and any ideas they might have for the study.

“The only way we can change the national screening programme would be to prove that this is acceptable and as accurate as delaying screening to 12 weeks.”

Dr Becky Newhouse, who has been working as a clinical fellow in gynae-oncology in Somerset for the last couple of years, said she was pleased to be involved in this piece of research.

“We’ve already done some preliminary work with women to find out about the challenges they’ve faced in getting a smear test, which is a good first step,” she said.

“We know that pregnancy and caring for a newborn is a very busy time, so it’s natural that a smear test may not be at the top of a to-do list. But this means a lot of women are out-of-date with their smear tests in pregnancy and we want to do everything we can to make it easy for them to get their test – the six-week GP appointment is ideal in so many ways.”

She added: “Sadly, cervical cancer is most prevalent in the age range around the usual childbearing age so we want to make sure smear testing is as accessible as possible for that group of women so they can get pre-cancerous changes detected as early as possible so they can be easily treated and stop them developing a cancer.”

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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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Study exposes gaps in menstrual health education in English schools

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A new study has revealed significant inadequacies in menstrual health education provision in English schools.

New research, led by the University of Bristol and Anglia Ruskin University, has highlighted a lack of practical information being offered, pupils being taught too late, and attitudes that perpetuate stigma across English schools.

Ten per cent of young women surveyed in the study, which sought to understand what and how menstrual health education information was delivered in English schools, did not receive or remember receiving any menstrual health education. Of those pupils who did, up to one in five did not receive education until after they had started their period.

Researchers surveyed 140 young women aged 18-24, who had attended either a private or state-funded primary and secondary school, on their menstrual health education. Of these, 99.3 per cent had experienced menstruation.

Participants were asked to take part in online surveys and in-depth interviews to share their experiences including what and how information was provided at school and reflect on their thoughts and feelings about their education.

From the survey results, researchers found lessons focussed on biological content with a lack of practical information needed to help students manage menstruation and menstrual health, with nearly seven in ten participants having reportedly received no practical information. None of the participants were taught about menstrual health conditions and only 3.2 per cent learnt about abnormal symptoms.

Serious long-term impacts were reported, as several participants put off seeking medical attention for debilitating symptoms because they thought their pain was normal, only to be later diagnosed with conditions such as endometriosis.

Overall, participants left school lacking basic knowledge and feeling ill-equipped with 62.4 per cent rating their education as “poor” or “very poor” in preparing them for managing menstruation.

In extreme cases, some were so unprepared that when they started their periods, they thought they were ill or even dying.

While schools were seen as an important source of information, many participants admitted that they had to rely on other sources, particularly the internet and social media.

Poppy Taylor, PhD researcher in population health sciences at the University of Bristol, and corresponding author, said: “Given the evidence that girls are starting their periods at ever-younger ages, there are concerns this will be too late for an increasing number of people. Denying young people with information about their bodies risks significant long-term harm.

“Our research provides strong evidence that the education system has been failing young girls and people who menstruate. We were shocked and disappointed, but sadly not surprised, with our findings.”

Globally, menstrual health is a key issue for gender equality. When menstrual needs are unmet, it can create barriers to education and employment, pose long-term health risks and threaten human rights.

Evidence suggests that persistent stigma and lack of public understanding about menstruation is preventing such needs from being met in the UK.

“Our findings suggest that for many young people, the menstrual health education they received failed to prepare them physically, mentally, or socially for their first period,” Taylor explained.

“We recommend that menstrual health education is improved through the delivery of earlier, more inclusive lessons with more practical content to ensure all young people are equipped to manage their menstrual health in a supportive environment.

“To support the UK government’s target of eradicating period stigma and poverty by 2030, universally accessible and comprehensive menstrual health education must be prioritised.”

The authors acknowledged that the reported experiences in the study, particularly from older participants, may not reflect current practices.

Due to the small sample size, they said, further research is needed to explore the experiences of students who are currently in the schooling system and to understand whether and how practices have changed.

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