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Women face ‘striking inequalities’ in NHS heart care, study shows

Women are less likely to get the treatment recommended in clinical guidelines if they have a heart attack or are diagnosed with heart failure

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Women face stark inequalities in diagnosis and treatment of four of the most common heart conditions in the UK, new research has shown.

The study, published in The Lancet Regional Health – Europe, found that women are less likely than men to undergo coronary angiograms, a crucial procedure to look inside their heart’s arteries, after a heart attack, and are less likely to be prescribed preventative treatments for heart attacks.

The findings, led by the University of Leeds and funded by the British Heart Foundation, highlighted an estimated 500 potentially avoidable deaths in the UK each year among patients waiting for treatment for aortic stenosis, a narrowing of the heart’s aortic valve which restricts blood flow around the body.

The British Heart Foundation said the research paints a “concerning picture of unequal care”, reinforcing the need for all political parties to prioritise efforts to tackle cardiovascular disease and health inequalities.

Professor Chris P Gale, professor of cardiovascular medicine at the University of Leeds and honorary consultant cardiologist at Leeds Teaching Hospitals NHS Trust who led the study, said: “We need urgent action to revive heart care.

“The NHS is full of fantastic people who make truly monumental efforts every day to do the very best for their patients. Despite this, the NHS is creaking at the seams and we see this played out in cardiovascular care and outcomes.

“Past efforts to transform heart care and drive down waiting lists were hugely successful and we must build on the lessons from these to move forward.”

He added: “It’s clear that we’re not making the most of NHS data and we’re missing vital opportunities for this to inform policy and help target investment.

“We need a systematic approach to collect data and report on all aspects of treatment, care and outcomes. Only then will we be able to improve patient’s experiences and outcomes across the board.”

Researchers brought together evidence from studies published over the last 20 years that explored how a person’s age, sex, ethnicity and postcode are linked to the heart care they receive and their outcomes.

The team focused on heart attacks, heart failure, atrial fibrillation and aortic stenosis as these conditions lead to significant pressure on the NHS.

Prompt treatment is crucial after a diagnosis of severe aortic stenosis, as around 50 per cent of patients will die within two years of symptoms beginning.

The review showed that older people and women are less likely to receive the treatment recommended in clinical guidelines if they have a heart attack or are diagnosed with heart failure.

While the evidence for age, sex and geography was clear, the researchers said it is harder to draw conclusions about the experiences of patients of different ethnicities due to a lack of evidence.

However, from the studies available they concluded that disparities do exist. For example, there was evidence that black patients with atrial fibrillation, a common type of abnormal heart rhythm, are less likely to receive blood thinning treatment to prevent stroke than white patients.

Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and consultant cardiologist, said: “These findings should sound the alarm bell for the state of heart care in the UK.

“This concerning review is further evidence that people’s experience of heart care was far from equal even before the pandemic began. The pandemic underlined and amplified existing health inequalities and we fear these are worse than ever now that we are firmly in the grip of a heart care crisis.”

She continued: “To stop this crisis in its tracks and address the unjust inequalities in heart care, we need bold action from the government. Protecting our hearts by tackling risk factors will help to prevent heart disease and strokes happening in the first place.

“Prioritising NHS heart care will allow people to get the help they need more quickly, preventing avoidable death and disability. And powering up research will unlock the treatments and cures of tomorrow to give more people hope for a bright and healthy future.”

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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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