Saturday August 21, 2010
The UK's Belfast Telegraph has an interesting report about a new technology developed by scientists that may hold promise for reducing the risk of stillbirth.
According to the article, researchers hope to be able to use CCTV (closed-circuit television) technology to create a wearable mobile monitoring device that would record the baby's heartbeat and movement patterns, potentially up to 24 hours a day, and alert the woman or her doctor immediately of significant changes to the baby's movement pattern that might indicate a problem.
When a baby suffers a complication that could lead to stillbirth, there is often a short window of time in which doctors can take action that might lead to the baby being saved, but often the problem is not noticed until it is already too late. For this reason, the planned device could make a very big difference for moms considered to have high risk for stillbirth -- such as those with recurrent past stillbirths.
The device is not yet developed, and may not hit the market for 10 years or more, but I think this initiative sounds quite promising and could potentially be a major step in stillbirth prevention.
Sunday August 15, 2010
According to a study reported in Business Week, and likely to the chagrin of anyone who's ever bristled at the advice to "just relax and it will happen," researchers have found evidence that high stress might impair women's ability to get pregnant.
Much past research on stress and fertility has looked at elevations of cortisol as a possible culprit, but this study looked at levels of alpha-amylase, a substance in saliva that digests starch but which is also increased when the body is under stress. Researchers had women who were trying to conceive keep charts of their cycles, and it was found that those with the highest alpha-amylase levels had a significantly lower chance of becoming pregnant each cycle compared to those with the lowest levels.
A researcher quoted in the article had this to say:
"It has been suggested that stress may increase with the disappointment of several failed attempts at getting pregnant, setting off a cycle in which pregnancy becomes even more difficult to achieve," Buck Louis said.
I hope research on this continues. Given that other research has suggested a link between stress and miscarriages, this finding is certainly interesting. It would seem possible that stress has a significant impact on how our bodies work, and if it really does affect pregnancy odds this much (or miscarriage odds), then healthcare providers certainly need to be involved in supporting women to reduce their stress levels.
More information:
Friday August 6, 2010
Although many doctors tell women to wait a number of months before getting pregnant after miscarriage, and the World Health Organization advises an oddly long wait of six months after miscarriage, a fairly large study by researchers at the University of Aberdeen has produced credible evidence that this wait is not medically necessary.
As reported by BBC News, researchers examined data from over 30,000 women who got pregnant after a miscarriage in their first pregnancies, and they found that those who conceived in less than six months following the miscarriage actually had a lower risk of another miscarriage and a lower risk of complications requiring a C-section or preterm delivery. Also, as an expert cites in the article, women who are over 35 face an increasing risk of pregnancy issues anyway, and advising these moms to wait several months after a miscarriage could be actively counterproductive.
I don't find this data at all surprising. There's never really been any credible evidence that any specific universal wait after miscarriage was medically necessary, nor that waiting would reduce the risk of further miscarriages. As was once pointed out to me by a fertility expert I was interviewing, the oft-cited need for the lining of the uterus to heal and build up isn't really credible given that your body is used to changing the uterine lining every month. It's theoretically possible that waiting one menstrual period after a D&C might be advisable, however, but there's no data on this.
It appears that the recommendations to wait after a miscarriage have been extrapolated from the numerous studies that show a lower risk of complications when women wait six to eighteen months between pregnancies, finding this as the optimal interval to reduce the risks in the subsequent pregnancy. But that data has come from following the subsequent pregnancies of women who gave birth after nine months and who were caring for babies at the time of the new pregnancy. A woman who gets pregnant a month or two after a first-trimester miscarriage can't be assumed to be in the same category as a woman who gets pregnant a month or two after a full-term delivery while also being under the physical stress of caring for a young infant. (One could as easily assume that sleep deprivation, a possible risk factor for pregnancy complications, was the reason for the increased risks in subsequent pregnancies of women who get pregnant again immediately after giving birth.)
In any case, I hope doctors will take note of this new evidence and incorporate it in their recommendations. Nevertheless, it's always wise to discuss your plans to conceive again with your doctor, as general recommendations don't always apply to individuals, and there could be specific issues in your personal medical situation that would affect when you should get pregnant again and whether a wait is necessary. You may also wish to wait before conceiving again for personal reasons, whether it's medically necessary or not. But hopefully these findings will reassure those couples who do wish to try again immediately after a loss and who have no complications preventing them from doing so.
More information:
Monday August 2, 2010
I was intrigued to see that Canadian newspapers are actively debating whether or not infertility treatment should be a right covered by Canada's public healthcare system. The hullabaloo is apparently due to the plans of Quebec to fund up to three IVF cycles for couples suffering from infertility, which according to The Globe and Mail will make it the first "jurisdiction" in North America to fund fertility treatment.
Given that infertility is a risk factor for miscarriages, and also given that some insurance companies in the US have in the past considered recurrent miscarriages to be under the same umbrella as infertility, I found the decision interesting. According to the little information I could find, infertility coverage wasn't addressed by recent healthcare reform bill passed in the US (except possibly those couples denied infertility coverage for the reason of it being a pre-existing condition, as reported by ABC News).
Those opposed to coverage of infertility typically assert that parenthood isn't a right and that infertility isn't a threat to a person's physical health, and insist that infertile couples should simply adopt, while those who support infertility coverage insist that real medical problems can cause infertility and that infertility is as worthy of coverage as any other medical problem that isn't life threatening.
Thoughts on the matter? Post them here.
