OB/GYN News Articles

Chemotherapy no longer required in 70 percent of breast cancer cases

New study says no chemotherapy needed to treat common breast cancer

A 21-gene test performed on tumors could enable most patients with the most common type of early breast cancer to safely forgo chemotherapy, according to a landmark study published in the New England Journal of Medicine.

Loyola Medicine oncologist Kathy Albain, MD, is among the main co-authors of the study and a member of the clinical trial's steering committee. First author is Joseph Sparano, MD, of Montefiore Medical Center in Bronx, N.Y. The study was published in conjunction with its Sunday, June 3 presentation at the plenary session of the American Society of Clinical Oncology 2018 meeting in Chicago.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer," Dr. Albain said. "For countless women and their doctors, the days of uncertainty are over."

Dr. Albain, the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine, has conducted research with the 21-gene test and also used it in her practice for years.

The test examines 21 genes from a patient's breast cancer biopsy sample to determine how active they are. The tumor is assigned a "recurrence score" from 0 to 100; the higher the score, the greater the chance the cancer will recur in distant organs and decrease survival. If patients with higher scores receive chemotherapy, this risk of recurrence will be significantly reduced, enabling more patients to be cured.

Previously, the challenge doctors and patients have faced is what to do if a patient has a mid-range score. It was uncertain whether the benefit of chemotherapy was great enough to justify the added risks and toxicity. Previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, while women with high scores (above 25) did require and benefit from chemotherapy.The new study examined the majority of women who fall in the intermediate range of 11 to 25.

The study enrolled 10,273 women who had the most common type of breast cancer (hormone-receptor positive, HER-2 negative) that had not spread to lymph nodes. Researchers examined outcomes of the 69 percent of patients who had intermediate scores on the 21-gene test.

Patients were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone. Researchers examined the chemotherapy and non-chemotherapy groups for several outcomes, including being cancer free, having cancer recur locally or to distant sites in the body and overall survival.

For the entire study population with gene test scores between 11 and 25 — and especially among women aged 50 to 75 — there was no significant difference between the chemotherapy and no chemotherapy groups. Among women younger than 50, outcomes were similar when gene test scores were 15 or lower. Among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group.

"The study should have a huge impact on doctors and patients," Dr. Albain said. "Its findings will greatly expand the number of patients who can forgo chemotherapy without compromising their outcomes. We are de-escalating toxic therapy."


Story Source: See this article on Science Daily: "More breast cancer patients can safely forgo chemotherapy: Study." ScienceDaily. ScienceDaily, 3 June 2018. www.sciencedaily.com/releases/2018/06/180603193614.htm. Materials provided by Loyola University Health System. Study published in the New England Journal of Medicine.

Focus on health risks for new mothers for Preeclampsia Awareness Month

May is Preeclampsia Awareness Month and NCMA Women’s OB/GYN Center joins with the Preeclampsia Foundation to help raise awareness. This year the foundation’s efforts are on postpartum preeclampsia as 97 percent of maternal deaths related to preeclampsia and other hypertensive disorders of pregnancy occur within just six weeks of delivery, a time when most new mothers might think the danger has passed.

A woman can develop preeclampsia after her baby is born, regardless of whether she experienced high blood pressure during her pregnancy. With such alarming statistics related to postpartum preeclampsia, it very important that a new mother remain vigilant and continue to monitor her heart health and blood pressure even after delivery.

Understanding preeclampsia

Postpartum preeclampsia is a serious condition related to high blood pressure. Women who have just delivered a baby are most at risk, although it has no effect on the baby. There is no known cause for preeclampsia to manifest in pregnant women. In many cases, women diagnosed with preeclampsia see symptoms abate following delivery, but the Preeclampsia Foundation emphasizes that ‘delivery is not a cure’. In some cases, symptoms begin during pregnancy, but some patients may not be symptomatic until after the baby is born. Postpartum preeclampsia most commonly occurs within the first seven days after delivery although new mothers remain at risk for up to six weeks following delivery.

Know the warning signs

Early diagnosis and being vigilant to symptoms followed by quick response is imperative to saving lives. Symptoms include (and can be complicated by lack of sleep, postpartum depression and/or simple lack of awareness about the signs):

  • nausea
  • swelling in hands/feet
  • severe headache
  • seeing spots or other vision changes
  • shortness of breath

When a patient thinks they are experiencing warning signs of postpartum preeclampsia, the first thing to do is go to the Emergency Department, request to be seen by an OB, and report that they have recently given birth. The first seven days after delivery is when women who experience preeclampsia are at highest risk. Effectively controlling high blood pressure is key to avoiding very serious health risks that include; seizures, stroke, organ damage and sometimes death.

About NCMA Women’s OBGYN Center

Our provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information, visit our website or call 707-579-1102.

New study says de-stress and enhance memory with dark chocolate

Feeling stressed? Get your happy on with dark chocolate

New research shows there might be health benefits to eating certain types of dark chocolate. Findings from two studies being presented today at the Experimental Biology 2018 annual meeting in San Diego show that consuming dark chocolate that has a high concentration of cacao (minimally 70% cacao, 30% organic cane sugar) has positive effects on stress levels, inflammation, mood, memory and immunity. While it is well known that cacao is a major source of flavonoids, this is the first time the effect has been studied in human subjects to determine how it can support cognitive, endocrine and cardiovascular health.

Lee S. Berk, DrPH, associate dean of research affairs, School of Allied Health Professions and a researcher in psychoneuroimmunology and food science from Loma Linda University, served as principal investigator on both studies.

"For years, we have looked at the influence of dark chocolate on neurological functions from the standpoint of sugar content -- the more sugar, the happier we are," Berk said. "This is the first time that we have looked at the impact of large amounts of cacao in doses as small as a regular-sized chocolate bar in humans over short or long periods of time, and are encouraged by the findings. These studies show us that the higher the concentration of cacao, the more positive the impact on cognition, memory, mood, immunity and other beneficial effects."

The flavonoids found in cacao are extremely potent antioxidants and anti-inflammatory agents, with known mechanisms beneficial for brain and cardiovascular health. The following results will be presented in live poster sessions during the Experimental Biology 2018 meeting:

Dark Chocolate (70% Cacao) Affects Human Gene Expression: Cacao Regulates Cellular Immune Response, Neural Signaling, and Sensory Perception

  • This pilot feasibility experimental trial examined the impact of 70 percent cacao chocolate consumption on human immune and dendritic cell gene expression, with focus on pro- and anti-inflammatory cytokines. Study findings show cacao consumption up-regulates multiple intracellular signaling pathways involved in T-cell activation, cellular immune response and genes involved in neural signaling and sensory perception — the latter potentially associated with the phenomena of brain hyperplasticity.

Dark Chocolate (70% Organic Cacao) Increases Acute and Chronic EEG Power Spectral Density (μv2) Response of Gamma Frequency (25-40Hz) for Brain Health: Enhancement of Neuroplasticity, Neural Synchrony, Cognitive Processing, Learning, Memory, Recall, and Mindfulness Meditation

  • This study assessed the electroencephalography (EEG) response to consuming 48 g of dark chocolate (70% cacao) after an acute period of time (30 mins) and after a chronic period of time (120 mins), on modulating brain frequencies 0-40Hz, specifically beneficial gamma frequency (25–40Hz). Findings show that this superfood of 70 percent cacao enhances neuroplasticity for behavioral and brain health benefits.

Berk said the studies require further investigation, specifically to determine the significance of these effects for immune cells and the brain in larger study populations. Further research is in progress to elaborate on the mechanisms that may be involved in the cause-and-effect brain-behavior relationship with cacao at this high concentration.


Story Source:

Materials provided by Loma Linda University Adventist Health Sciences Center. Note: Content may be edited for style and length.


Read this article on Science Daily: Loma Linda University Adventist Health Sciences Center. "Dark chocolate consumption reduces stress and inflammation: Data represent first human trials examining the impact of dark chocolate consumption on cognition and other brain functions." ScienceDaily. ScienceDaily, 24 April 2018. www.sciencedaily.com/releases/2018/04/180424133628.htm.

Pasta and rice hastens menopause according to new study

high dietary intake of refined carbs, such as pasta and rice, may instead help to hasten menopause

Fish and Legumes May Delay Onset of Menopause

A diet rich in fish and legumes may help to delay the natural menopause, while high dietary intake of refined carbs, such as pasta and rice, may instead help to hasten it, suggests the first UK study of its kind, published online in the Journal of Epidemiology & Community Health.

Several genetic, behavioral, and environmental factors are thought to be involved in the timing of the menopause, and some studies have implicated diet.

To explore this further, the researchers drew on participants from the UK Women's Cohort Study, involving more than 35,000 women between the ages of 35 and 69 from England, Scotland, and Wales.

The women provided information on potentially influential factors such as weight history, physical activity levels, reproductive history, and use of hormone replacement therapy (HRT).

They also estimated the quantities of 217 foodstuffs they ate every day by completing a food frequency questionnaire. The food items were collated into groups according to their culinary uses.

Further information on when the women had gone through the menopause naturally was gathered four years later.

In all, some 14,000 women provided information at both time points, and the final analysis included the 914 who had gone through the menopause naturally after the age of 40 and before the age of 65.

The average age at menopause was 51, and certain foods seemed to be associated with its timing.

Each additional daily portion of refined carbs — specifically pasta and rice — was associated with reaching the menopause 1.5 years earlier, after taking account of potentially influential factors.

But each additional portion of oily fish and fresh legumes (eg peas, beans) was associated with a delay of more than three years. Higher intakes of vitamin B6 and zinc (mg/day) were also associated with later menopause.

Similar results emerged when the analysis looked at particular groups. For example, eating meat was associated with menopause arriving almost a year later than a vegetarian diet.

Among those who weren't vegetarian, upping daily portions of savoury snacks was associated with the arrival of the menopause almost 2 years earlier, while higher intake of oily fish and fresh legumes was linked to later menopause of more than 3 and nearly 1.5 years, respectively.

Similarly, among mothers, higher intake of oily fish and fresh legumes was associated with later menopause, while additional daily portions of pasta, rice, and savoury snacks were associated with earlier menopause.

Among childless women, eating more grapes and poultry was significantly associated with later menopause.

Egg maturation and release are adversely affected by reactive oxygen species, so a high intake of legumes, which contain antioxidants, may counter this, preserving menstruation for longer, suggest the researchers, in a bid to explain the findings. And omega 3 fatty acids, which are abundant in oily fish, stimulate antioxidant capacity in the body.

On the other hand, refined carbs boost the risk of insulin resistance, which can interfere with sex hormone activity and boost oestrogen levels, both of which might increase the number of menstrual cycles and deplete egg supply faster, they say.

Vegetarians consume a lot of antioxidants too, but they are also likely to eat a lot more fibre and less animal fat than carnivores, both of which are associated with low oestrogen levels, which may also alter the timing of the menopause, suggest the researchers.

This is an observational study, and as such, can't prove causality. Food Frequency Questionnaires are subject to faulty recall, and the study sample was also more affluent and health conscious than average, all of which might have influenced the findings.

But women who go through the menopause early are at increased risk of osteoporosis and heart disease, while those who go through it late are at increased risk of breast, womb, and ovarian cancers, so timing matters, say the researchers.

And they conclude: "Our findings confirm that diet may be associated with the age at natural menopause. This may be relevant at a public health level since age at natural menopause may have implications on future health outcomes."


Story Source:

Materials provided by BMJ. Note: Content may be edited for style and length.


Journal Reference:

  1. Yashvee Dunneram, Darren Charles Greenwood, Victoria J Burley, Janet E Cade. Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study. Journal of Epidemiology and Community Health, 2018; DOI: 10.1136/jech-2017-209887

Read this article on Science Daily: " ScienceDaily. ScienceDaily, 30 April 2018.  www.sciencedaily.com/releases/2018/04/180430212400.htm .

Research addresses concern over hormonal contraceptive side effects

The vast majority of women will use some method of contraception during their lifetime. Despite there being 37 million in the United States who are currently on birth control, many still worry about potential side effects. Women face several options when it comes to birth control, so potential side effects often factor into their decision. Depression is a common concern for many women, but a new study by researchers at The Ohio State University Wexner Medical Center is putting patients at ease. It found there’s no evidence to support a link between hormonal birth control and depression.

“Depression is a concern for a lot of women when they’re starting hormonal contraception, particularly when they’re using specific types that have progesterone,” said Dr. Brett Worly, lead author of the study and OB/GYN at Ohio State Wexner Medical Center. “Based on our findings, this side effect shouldn’t be a concern for most women, and they should feel comfortable knowing they’re making a safe choice.”

Worly and his team reviewed thousands of studies on the mental health effects of contraceptives. They included data tied to various contraception methods, including injections, implants and pills. Similarly, researchers reviewed studies examining the effects of hormonal birth control on postpartum women, adolescents and women with a history of depression, all with the same conclusion: there is insufficient evidence to prove a link between birth control and depression.

“Adolescents and pregnant moms will sometimes have a higher risk of depression, not necessarily because of the medicine they’re taking, but because they have that risk to start with,” said Worly. “For those patients, it’s important that they have a good relationship with their healthcare provider so they can get the appropriate screening done — regardless of the medications they’re on.”

Worly said patient concerns are valid, and he wants women to continue having open and honest discussions with their doctor about which options work for them.

“We live in a media-savvy age where if one or a few people have severe side effects, all of a sudden, that gets amplified to every single person,” he said. “The biggest misconception is that birth control leads to depression. For most patients that’s just not the case.”

Most women have tried at least one method of contraception in their lives, with nearly 37 million women in the United States currently using birth control. Sixty-seven percent of current users have opted for a non-permanent hormonal method such as an oral pill, but among those, 30 percent have discontinued their use due to dissatisfaction with potential side effects.


Story Source: Read this article on Science Daily: The Ohio State University Wexner Medical Center. “No link between hormonal birth control and depression: Research eases fear around hormonal contraceptive side effects.” ScienceDaily. ScienceDaily, 26 February 2018. www.sciencedaily.com/releases/2018/02/180226085756.htm.

Robotic gynecologic surgery now available in Santa Rosa

 

Our most notable robotic-assisted procedures are hysterectomies for the treatment of a variety of conditions.NCMA’s Women’s OB/GYN is excited to announce new services offered by Tara Bartlett, D.O., and Melissa Seeker M.D., gynecological surgeons. Together, Dr. Bartlett and Dr. Seeker started the gynecologic robotics program at Memorial Hospital with a focus on a minimally invasive approach for benign hysterectomies.

Using the da Vinci® surgical system for robotic procedures each surgeon is able to be  100% in control of the robotic platform, which offers high definition 3D views and translates our hand movements into small, precise movements of the advanced EndoWrist® instruments. That means we have enhanced vision, dexterity and precision and our patients experience faster operating times, small incisions, reduced length of stay, and less conversion to open procedures on tough cases with scar tissue or fibroid uterus.

The Women’s OB/GYN Medical Group now offers robotic-assisted minimally invasive surgery for patients with:

  • heavy menstrual bleeding
  • uterine fibroids or adenomyosis
  • genetic cancer syndromes such as BRCA or Lynch Syndrome
  • endometriosis or chronic pelvic pain
  • ovarian cysts

Dr. Bartlett and Dr. Seeker’s most notable robotic-assisted procedures are hysterectomies for the treatment of the above listed conditions. For more information visit the robotics section of our website and to schedule a consultation, please call our office at 707-579-1102.

Study reveals no increase in risks for women who eat and drink during labor

At most US maternity units, women in labor are put on nil per os (NPO) status -- they're not allowed to eat or drink anything, except ice chips. But new nursing research questions that policy, showing no increase in risks for women who are allowed to eat and drink during labor.

At most US maternity units, women in labor are put on nil per os (NPO) status — they’re not allowed to eat or drink anything, except ice chips. But new nursing research questions that policy, showing no increase in risks for women who are allowed to eat and drink during labor. The study appears in the March issue of the American Journal of Nursing, published by Wolters Kluwer.

“The findings of this study support relaxing the restrictions on oral intake in cases of uncomplicated labor,” write Anne Shea-Lewis, BSN, RN, of St. Charles Hospital, Port Jefferson, N.Y., and colleagues. Adding to the findings of previous reports, these results suggest that allowing laboring women to eat and drink “ad lib” doesn’t adversely affect maternal and neonatal outcomes.

No Increase in Complications with ‘Ad lib’ Oral Intake During Labor

The researchers analyzed the medical records of nearly 2,800 women in labor admitted to one hospital from 2008 through 2012. At the study hospital, one practice group of nurses and doctors had a policy of allowing laboring women to eat and drink ad lib (ad libitum, or “as they please”). Another four practice groups kept all patients NPO (nil per os, or “nothing by mouth”).

Recommendations to restrict oral intake during labor reflect concerns over the risk of vomiting and aspiration (inhalation) in case general anesthesia and surgery are needed. However, with advances in epidural and spinal anesthesia, the use of general anesthesia during labor has become rare (and, if needed, much safer than before).

The study compared maternal and child outcomes in about 1,600 women who were kept NPO (except for ice chips) with 1,200 who were allowed to eat and drink ad lib during labor. The two groups were “sufficiently equivalent” for comparison. The women’s average age was 31 years. Before delivery, a “preexisting medical condition” complicating pregnancy was identified in 14 percent of the NPO group compared with 20 percent of the ad lib group.

Even though the women in the NPO group started out with fewer medical problems, they had a significantly higher incidence of complications during labor and birth, compared with the ad lib group. The women in the NPO group were also significantly more likely to give birth via unplanned cesarean section.

Other outcomes — including requiring a higher level of care after delivery and the newborns’ condition as measured by Apgar score — were not significantly different between groups. Analysis using a technique called propensity score matching, comparing groups of women with similar risk factors, yielded similar results.

The findings add to those of previous studies suggesting that restrictions on eating and drinking during labor could be safely relaxed in uncomplicated cases. “Yet in keeping with current guidelines, most obstetricians and anesthesiologists in the United States continue to recommend restrictions on oral intake for laboring women,” Anne Shea-Lewis and colleagues write.

“Our findings support permitting women who are at low risk for an operative birth to self-regulate their intake of both solid food and liquids during labor,” the researchers add. They note some limitations of their study, especially the fact that the women weren’t randomly assigned to NPO or ad lib groups.

The authors hope their study will lead to reconsideration of current recommendations to keep women NPO during the “often long and grueling” process of labor and delivery. “Restricting oral intake to a laboring woman who is hungry or thirsty may intensify her stress,” Anne Shea-Lewis and colleagues conclude. “Conversely, allowing her to eat and drink ad lib during labor can contribute to both her comfort and her sense of autonomy.”

Story Source:

Read this article on Science Daily: Wolters Kluwer Health. “Ice chips only? Study questions restrictions on oral intake for women in labor.” ScienceDaily. ScienceDaily, 23 February 2018. www.sciencedaily.com/releases/2018/02/180223151852.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

The Women’s OB/GYN Medical Group of Santa Rosa focuses on Heart Health for February

With February being Heart Health Awareness Month the Women’s OB/GYN Medical Group seeks to expand on the American Heart Association’s (AHA) focus on heart health. Dr. Tara Bartlett, D.O. shares some tips on what women need to be on the lookout for, along with some ideas for staying healthy.

With February being Heart Health Awareness Month the Women’s OB/GYN Medical Group seeks to expand on the American Heart Association’s (AHA) focus on heart health. In this article the group shares some tips on what women need to be on the lookout for, along with some tips for staying healthy.

According to the AHA women may have a slightly lower incidence of cardiovascular disease (35 percent compared to 37.4 percent for men) but they are more likely to die from cardiovascular disease than are men. As many as one out of three deaths among women are attributed to heart disease. Perhaps the most alarming statistic is the one that puts 90 percent of all women in the crosshairs for having one or more risk factors for heart disease or stroke.

It’s all about healthy living

There is some good news in the world of facts about women and heart health – 80 percent of heart disease and stroke events could be prevented simply by making a few lifestyle changes. Becoming educated about cardiovascular disease is also important. At the top of the list of increasing a woman’s chance of surviving cardiovascular disease is learning the signs and symptoms of heart disease and heart attacks before they happen. Among the things women can to do get and stay heart healthy includes: taking up a healthy diet of whole foods (avoiding processed alternatives), keeping weight at a normal BMI level, getting plenty of exercise (at least 20 minutes a day), controlling high blood pressure if you have it, avoiding excess salt and not smoking.

Fitness is a factor for women of all ages, and even more significant for those who have known risk factors for heart disease and stroke. Making specific lifestyle changes is one of the most effective ways to maintain a healthy heart.

Signs to watch out for

When it comes to heart attacks, a cardiovascular event can be very different for women when compared to what men experience. Women’s symptoms tend to be much milder and less specific than men’s and may include seemingly innocuous symptoms such as fatigue, sleep problems, indigestion and weakness in the arms. Some women experience a sense of foreboding for no apparent reason. These symptoms are often missed, or dismissed, by women and misdiagnosed by health care professionals.

There has been quite a bit of discussion lately about the fact that women are often treated less aggressively by medical professionals once they’ve had a heart attack. They are also reportedly less likely than men to receive medications that prevent future heart events such as beta blockers, statins and ACE inhibitors.

When women are empowered to understand the signs and symptoms of cardiovascular disease, they have a greater opportunity to be proactive about their own healthcare. It’s more important than ever for women to be educated about heart disease, as it’s the leading cause of death for both women and men in this country.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit the website.

Mediterranean diet may boost fertility in women undergoing IVF

women who follow a 'Mediterranean' diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

New research has found that women who follow a ‘Mediterranean’ diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

New research has found that women who follow a “Mediterranean” diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

Researchers asked women about their diet before they underwent in vitro fertilisation (IVF) treatment and found that those who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil, and less red meat, had a 65-68% greater likelihood of achieving a successful pregnancy and birth compared to women with the lowest adherence to the Mediterranean-style diet.

The study, which is published today (Tuesday) in Human Reproduction, focused on dietary patterns rather than individual nutrients, foods or food groups. It assessed the diet of 244 women via a food frequency questionnaire when they enrolled at an Assisted Conception Unity in Athens, Greece, for their first IVF treatment. The questionnaire asked them about how often they ate certain groups of food in the preceding six months; the results gave the women a MedDiet Score, which ranged from 0-55 with higher scores indicating greater adherence to the Mediterranean diet. The women were aged between 22-41 and were non-obese (body mass index of less than 30 kg/m2).

Researchers, led by Associate Professor Nikos Yiannakouris at the Department of Nutrition and Dietetics at Harokopio University of Athens, divided the women into three groups depending on their MedDiet Score: the first group had scores between 18 to 30, the second scored between 31-35 and the third group scored between 36 to 47.

They found that compared to the 86 women in the highest scoring group, the 79 women in the lowest scoring group had significantly lower rates of pregnancies (29% versus 50%) and live births (26.6% versus 48.8%). When the researchers looked at women younger than 35 years old, they found that every five-point improvement in the MedDiet Score was linked with an approximately 2.7 times higher likelihood of achieving a successful pregnancy and live birth.

Overall, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby.

“The important message from our study is that women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may help increase the chances of successful pregnancy and delivering a live baby,” said Prof Yiannakouris.

“It should be noted that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. Previous work from our research group among the male partners of our study has suggested that adherence to the Mediterranean diet may also help improve semen quality. Taken together, these findings highlight the importance of dietary influences and diet quality on fertility, and support a favourable role for the Mediterranean diet on assisted reproduction performance.”

The researchers did not find any association between diet and the chances of successful pregnancies and live births among women aged 35 and older. However, they believe this is because hormonal changes, fewer available eggs and other changes that women experience as they get older could mask the influences of environmental factors such as diet.

Prof Yiannakouris said: “The fact that in our study a favourable effect of the Mediterranean diet was evident only among women younger than 35 years doesn’t mean that eating a healthy diet is not as important for older women. Our results suggest the need for additional research not only among older women, but also among women with obesity problems and in women conceiving naturally.”

The researchers say that their findings cannot be generalised to all women trying to become pregnant, nor to obese women or women attending other infertility clinics around the world. They point out that their findings show that a Mediterranean diet is only linked to improved IVF outcomes and they cannot show that it causes the improved chances of pregnancy and birth.

“Our findings provide support that couples undergoing infertility treatment may benefit by adhering to the Mediterranean diet (a diet widely accepted for its positive effects on human health); however, whether or not advice to adhere more closely to this traditional diet would improve assisted reproduction performance needs to be addressed in future intervention studies. Moreover, our results should be explored and confirmed in other populations within and beyond the Mediterranean region. Clearly more research and intervention studies are needed to elucidate the role of diet quality in assisted reproductive performance, to reveal underlying mechanisms, and for developing nutritional guidelines for women to further improve fertility treatment and success rates.

“As more couples worldwide face infertility problems and seek access to assisted reproduction technologies to conceive, it is essential for them to receive counselling on the importance of dietary influences and of adopting a healthy lifestyle,” concluded Prof Yiannakouris.


Story Source:

Materials provided by European Society of Human Reproduction and Embryology. Note: Content may be edited for style and length.


Journal References:

Dimitrios Karayiannis, Meropi D Kontogianni, Christina Mendorou, Minas Mastrominas, Nikos Yiannakouris. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction, 2018; DOI: 10.1093/humrep/dey003

Dimitrios Karayiannis, Meropi D. Kontogianni, Christina Mendorou, Lygeri Douka, Minas Mastrominas, Nikos Yiannakouris. Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human Reproduction, 2016; DOI: 10.1093/humrep/dew288


Read this article on Science Daily: European Society of Human Reproduction and Embryology. “Mediterranean diet may help women receiving IVF to achieve successful pregnancies.” ScienceDaily. ScienceDaily, 29 January 2018. www.sciencedaily.com/releases/2018/01/180129223846.htm.

Risk of heart disease goes up with breast cancer treatment

Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.

Breast cancer patients may be at an increased risk of cardiovascular diseases including heart failure and may benefit from a treatment approach that weighs the benefits of specific therapies against potential damage to the heart, according to a new scientific statement from the American Heart Association published in its journal Circulation.

The statement is an overview of what we currently know about risk factors common to both heart disease and breast cancer, the potential heart damage from some breast cancer treatments, and suggested strategies to prevent or minimize the damage. Breast cancer survivors, especially older women over the age of 65, are more likely to die from cardiovascular disease than breast cancer, underscoring the importance of effectively managing heart disease risk factors during and following cancer treatment.

“Any patient who is going to undergo breast cancer treatment, whether they have heart disease at the beginning or not, should be aware of the potential effects of the treatments on their heart,” said Laxmi Mehta, M.D., chair of the writing group for the new scientific statement. “This should not deter or scare patients from undergoing breast cancer treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

During cancer treatments, patients should pay attention not only to their breast health, but also to their general health, including their heart, said Dr. Mehta, who is director of the Women’s Cardiovascular Health Program and an associate professor of medicine at The Ohio State University in Columbus, Ohio.

For example, some cancer treatments, such as HER-2 targeted therapies, can cause weakening of the heart muscle, a condition known as heart failure. HER-2 is a specific type of breast cancer. In some cases, the reduction in heart function is temporary and cessation of the treatment and/or the addition of heart medicines can improve function. But in some breast cancer patients, heart failure can be permanent. Because of this, the early development of heart failure can signal a need to slow down and/or alter a patient’s breast cancer treatment because of the risk for worsening the condition or the development of permanent heart failure.

Some small studies suggest that administering common chemotherapy agents in new ways may reduce heart disease risks. Doxorubicin is a chemotherapy drug used in breast cancer therapy that can lead to the damage of heart cells. Studies have shown that when doxorubicin is administered slowly, rather than all at once, patients may have a lower risk of heart failure.

In addition, a drug called dexrazoxane that could reduce cell damage has recently been approved for patients with metastatic breast cancer who receive high doses of doxorubicin. More studies will need to be done to confirm whether the results of the smaller studies are seen in larger groups of patients.

Other treatments, such as radiation, can affect the heart arteries and cause the development of coronary artery disease or blockages. Some breast cancer treatment agents, such as anthracyclines, can result in abnormal heart rhythms that in some patients are benign but in others can lead to life-threatening heart rhythms. And, some treatments — like antimetabolites — can cause spasm of the heart arteries, which can cause chest pain symptoms but could lead to heart attacks as well.

Heart disease and breast cancer share a number of risk factors, including advanced age, poor diet, family history, physical inactivity and tobacco use. The fact that these diseases share some risk factors suggests that there are lifestyle choices, primarily diet and exercise, that could help decrease the risks of developing both diseases. Healthcare providers should monitor a woman’s heart health before, during and after breast cancer treatment.

Adherence to a number of ideal heart health behaviors or factors from the American Heart Association’s’ Life’s Simple 7 is associated with a trend towards a lower incidence of breast cancer. Life’s Simple 7 includes being physically active, achieving and maintaining a healthy body weight, eating a healthy diet, avoiding tobacco, maintaining healthy levels of blood pressure, cholesterol and blood sugar.

“Fortunately, with the advances in breast cancer treatment, there has been a growing number of survivors. However, during and after the treatment of breast cancer, having optimal control of heart disease risk factors is important, because older breast cancer survivors are more likely to die of heart disease than breast cancer,” Dr. Mehta said. “And that’s why Life’s Simple 7 is important for all patients with and without breast cancer.”

Although there are an estimated 47.8 million women in the U.S. who are living with cardiovascular diseases and approximately 3 million breast cancer survivors, many people regard breast cancer as the primary threat to women’s health. It is important to recognize the overlap of heart disease and breast cancer as both entities impact survival.

Story Source: Read this article on Science Daily: American Heart Association. “Breast cancer treatments may increase the risk of heart disease: American Heart Association scientific statement.” ScienceDaily. ScienceDaily, 1 February 2018. www.sciencedaily.com/releases/2018/02/180201085812.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com