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Archive for the ‘Preventative Care’ Category

Effect on the chance of subsequent pregnancy quantified for first time

Date:July 3, 2017

Source:European Society of Human Reproduction and Embryology

For the first time, a large population study has quantified the chance of pregnancy after treatment for cancer diagnosed in girls and women aged 39 or under. This landmark study, which linked all cancers diagnosed in Scotland between 1981 and 2012 to subsequent pregnancy, found that the cancer survivors were 38% less likely to achieve a pregnancy than women in the general population. This detrimental effect on fertility was evident in almost all types of cancer diagnosed.

“This analysis provides the first robust, population-based evidence of the effect of cancer and its treatment on subsequent pregnancy across the full reproductive age range,” said presenter Professor Richard Anderson from the MRC Centre for Reproductive Health, Queen’s Medical Research Institute at the University of Edinburgh, UK.

“The major impact on pregnancy after some common cancers highlights the need for enhanced strategies to preserve fertility in girls and young women.”

Professor Anderson will present the results of the study today at the Annual Meeting of ESHRE in Geneva.

The need for better access to fertility preservation has become more pressing in recent years for two reasons: first, the improved rates of survival in young women and girls diagnosed with cancer; and second, improvements in the techniques of freezing eggs and ovarian tissue to restore fertility.

This latest study, which cross-linked 23,201 female cancer survivors from the Scottish Cancer Registry with hospital discharge records, revealed 6627 pregnancies among the cancer survivors when nearly 11,000 would have been expected in a comparable matched control group from the general population.

For women who had not been pregnant before their cancer diagnosis, 20.6% of the cancer survivors achieved a first pregnancy after diagnosis (2114 first pregnancies in 10,271 women), compared with 38.7% in the control group. Thus, women with cancer were about half as likely to achieve a first pregnancy after diagnosis as were controls.

The analysis also found that the chance of pregnancy was reduced in all age groups, with substantial variations between different cancer diagnoses — notably, reduced pregnancy rates in women with cervical cancer, breast cancer and leukemia. However, those cancers diagnosed later within the study period (2005-2012) were associated with higher rates of pregnancy than those diagnosed earlier (1981-1988), suggesting that for some cancer treatments the impact on fertility has reduced.

The diagnosis and treatment of female cancers are known to affect fertility for several reasons: some chemotherapy regimens can cause damage to the ovary, and this can occur at any age; radiotherapy can also compromise female fertility through effects on the ovary, uterus and potentially those brain centres which control the reproductive axis.

However, Professor Anderson stressed that the results of the study related only to subsequent pregnancy itself, and not to the incidence of infertility caused by cancer treatment. “Some women may have chosen not to have a pregnancy,” he explained. “Thus, while these results do show an expected reduction in the chance of pregnancy after chemotherapy and radiotherapy, having a pregnancy after cancer does involve a range of complex issues that we cannot address in this study.”

With rates of cancer survival increasing in both young male and females, fertility preservation ahead of treatment has an increasing role to play in fertility clinics. However, Professor Anderson described such services in all parts of the world, including the USA and Europe, as “very variable.” “Oocyte and embryo freezing are regarded as established,” he said, “but ovarian tissue cryopreservation is considered experimental, although it is the only option for prepubertal girls.”

He added that the results of this study would allow clinicians to advise girls and women more accurately about their future chance of pregnancy. “They emphasise the need to consider the possible effects on fertility in girls and women with a new cancer diagnosis. The implications of the diagnosis and planned treatment and, where appropriate, options for fertility preservation should be discussed with the patient and her family. Even for patients considered at low risk of infertility as a result of treatment, a fertility discussion is recommended before treatment begins.”

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Congress in Session

Today or tomorrow, the U.S. House of Representatives will pass a bill that repeals the Healthcare Reform Act that was signed into law last year.  That, of course, is the law that has generated so much controversy in this country.  I personally support this much needed law.

If you also support this law, don’t worry at all when you hear that the House has repealed it.  It’s all a big show.

The Republican Party campaigned in 2010 promising to repeal the law.  And they will take this first step.  But that’s as far as it will go.  The next step would be for the repeal to be considered by the U.S. Senate and the Democratic Party still runs things over there.  But, let’s think worst case scenario.  Let’s say that the Senate also repeals the law.    In that case, the next step is the repeal legislation would go to the President and guess what he will do?   He’ll veto the bill.

When a bill is vetoed, it goes back to the House and the Senate.  Both of those bodies can override what the President did but they have to get two-thirds of their body to vote for repeal.  And the Republicans don’t have those numbers.

So, you can watch what is going on with interest if you’ve got nothing to do.   The Republicans are just doing this so they can go back to their constituents and tell them that they “fought” to repeal that “horrible law.”

But, relax folks.  It’s all part of the show.

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John Boehner

At this point, I assume you know that a new health care system is being implemented in this country.  If you don’t know this then…..well, there is no sense in reading this cause, honey, you are on another planet.

We’ve heard all the arguing and seen some of the commercials and watched the elections and all.  We’ve heard how the new Speaker of the House, John Boehner, has vowed to repeal the new law.  Well, that’s a total crock because while the House of Representatives will vote to repeal it, it’s unlikely that the Senate will do the same and, if by some chance they do repeal it, well, Obama-Man is sitting there with his ole veto pen.  End of story.

We’re gonna be living with this new law for some time.  That being the case, I thought I would regularly send you a short explanation of what all of this means to you to cut through all of the stuff that you see and don’t have time to sort out.

A number of the provisions of the law will not take effect for quite a while, but some things are already in effect.  So, right now, here’s the deal:

Any health plan that you get through your job or any new individual plan has to let any kids you have under 19 to have coverage.  In other words, they cannot be denied coverage if they are already sick or have some medical condition.

If your health insurance allows you to have coverage for your dependents, then they can be covered until they are 26 years old.  After that, you kick them out of the house and they’re on their own.

Insurance companies cannot drop you from their plans when you get sick just because you made a mistake on your coverage application.

Many insurance companies say that during your lifetime you can only be covered up to a certain point.  Today, there are no limits.

If your employer offers a health plan, you generally can’t be turned away or charged a higher premium because of your health status or disability.  This protection is called “nondiscrimination.”

If family members are eligible but are not currently enrolled under your health plan at work, you may be able to add them during a “special enrollment” opportunity outside of the usual “open enrollment” period.

Not too shabby, huh?

There’s so much more to come!  Stay tuned.

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