pregnant Archives - Amazing Health Advances

IVF Pregnancies at Greater Risk of Exposure to Medicines That Can Harm the Baby

The AHA! Team — Tue, 04 Feb 2025 06:09:30 +0000

University of South Australia via Newswise – Pregnancies achieved through IVF and ICSI have the highest exposure to medicines that can harm the fetus, raising the chances of birth defects. A new Australian study has revealed a potential reason why some pregnancies achieved through assisted reproductive technology (ART) may result in birth defects in comparison to naturally conceived pregnancies. Researchers found that in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) pregnancies had the highest exposure to teratogenic medicines that potentially can harm the fetus during the first trimester of pregnancy. These are listed as Category D and X medicines by Australia’s Therapeutic Goods Administration (TGA). The risk associated with the use of Category D medicines in pregnancy may be outweighed by the clinical benefit in individual cases such as management of mental health disorders or epilepsy. Category X medicines on the other hand are strongly discouraged during pregnancy due to the high risk of fetal harm. Researchers from the University of South Australia (UniSA), The University of Western Australia (UWA) and The Kids Research Institute Australia analysed more than 57,000 pregnancies in four conception groups over a two-year period. The groups comprised women using ART (2041); those taking medication to induce ovulation (590); untreated sub-fertile women (2063); and naturally fertile pregnancies (52,987). ART pregnancies had the highest exposure to Category D medications taken in the first trimester. The study found that 4.9% of the ART pregnancies were exposed, compared to only 0.6% of naturally conceived pregnancies. In later trimesters, the trend persisted, with 3.4% of ART pregnancies exposed to Category D medications versus 0.6% of naturally conceived pregnancies. Exposure to Category X medications (causing the most harm during pregnancy) was low across all groups and trimesters, at less than 0.5% of pregnancies. “These differences in exposure are primarily linked to medications used as additional treatment following ART to prevent repeat miscarriages or failed implantation, rather than medications to treat underlying chronic conditions,” says UniSA researcher Dr Anna Kemp-Casey, who led the study. “For example, ART pregnancies, during the study period were more often exposed to progestogens like medroxyprogesterone acetate, which may have been used to treat threatened or recurrent miscarriages,” Dr Kemp says. The five most frequently used Category D/X medications across all pregnancies regardless of conception status were paroxetine, lamotrigine, valproic acid, carbamazepine, and nicotine dependence treatments. UWA co-researcher Professor Roger Hart, also a practising IVF clinician and the national medical director of City Fertility, says the higher exposure to Category D and X medicines in ART pregnancies during the first trimester may contribute to the higher rate of birth defects observed in ART babies. “Although ART pregnancies are carefully planned, medications taken during fertility treatments may inadvertently increase exposure to birth defect risks, particularly during critical periods of fetal development,” Prof Hart says. Researchers say the findings demonstrate that the vast majority of IVF babies are healthy, and do not suggest that ART pregnancies are unsafe, but they underscore the importance of personalised medical care for women undergoing ART treatment and close monitoring for women in early pregnancy. Prof Hart says more research is needed to examine Category D and X medicines exposure in pregnancy as well as underlying maternal medical conditions and their contribution to birth defect risk in ART babies. The study has been published in the Australian and New Zealand Journal of Obstetrics and Gynaecology. Notes for editors “Are assisted reproductive technology pregnancies more likely to be exposed to teratogenic medication? A whole-population study” is authored by researchers from the University of South Australia, Telethon Kids Institute, The University of Western Australia and Curtin University. DOI: 10.1111/ajo.13911 According to the latest ANZARD report, in 2022 more than 20,000 children in Australia (17,963) and New Zealand (2095) were born using ART. Since IVF was introduced in 1978, 10 million children have been born using ART. A 2021 study by US researchers analyzing 1.2 million births found an 18% higher risk of birth defects among IVF babies and a 36% overall greater risk for ICSI births (42% increased risk where ICSI was used to treat male factor subfertility and 30% increased risk with ICSI use for non-male factor subfertility). In IVF pregnancies, sperm is added to a dish containing eggs, and fertilisation occurs naturally, compared to ICSI where a single sperm is injected directly into each egg. The latter procedure is normally used to treat male subfertility but is also an option for unexplained infertility. To read the original article click here.

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Experimental Treatment Offers Hope of Fertility for Early Menopausal Women

AHA Publisher — Fri, 02 Apr 2021 07:00:20 +0000

The North American Menopause Society (NAMS) via EurekAlert – Menopause typically signals the end of a woman’s ability to become pregnant. However, in a small new study, a novel approach of administering platelet-rich plasma and gonadotropins near the ovarian follicles is showing promise in restoring ovarian function. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS). As more women look to build their careers before pursuing motherhood, the average age of conceiving a child continues to be pushed back. For some of these women, however, their hope of becoming pregnant is cut short by the onset of early menopause, which is described as the cessation of ovarian function at or before the age of 45 years. It is estimated that roughly 12.2% of women experience early menopause. For these women, the only chance of becoming pregnant is with donor eggs. Multiple treatment options have previously been investigated, including standard, controlled ovarian stimulation. Platelet-rich plasma has been used in women with primary ovarian insufficiency, but few pregnancies and live births resulted. With the failure of these somewhat traditional treatments, more novel approaches, such as methods for inducing the growth of ovarian follicles, are being pursued. In this new, small-scale pilot study, platelet-rich plasma and gonadotropins were injected into the ovaries of study participants, with some fairly amazing results. After treatment, 11 of the 12 study participants resumed menstruation, and one achieved clinical pregnancy, defined as a pregnancy that is confirmed by ultrasound as well as a fetal heartbeat. Although more research and larger studies are needed, these early results regarding the successful resumption of ovarian function offer hope to women in early menopause who may be able to pursue pregnancy through in vitro fertilization using their own eggs. Results are published in the article “Resumed ovarian function and pregnancy in early menopausal women by whole dimension subcortical ovarian administration of platelet-rich plasma and gonadotropins.” “This pilot study investigating the use of platelet-rich plasma and gonadotropins injected into the ovaries of women with early menopause highlights the promise of regenerative medicine in restoring or prolonging fertility. Additional studies conducted prospectively and involving large numbers of women are needed to determine whether this is truly a viable option for women with early menopause hoping to achieve pregnancy using their own eggs,” says Dr. Stephanie Faubion, NAMS medical director. To read the original article click here.

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Developing Therapeutic Strategies for Pregnant Women with Lupus

AHA Publisher — Tue, 17 Sep 2019 05:00:46 +0000

Virginia Tech via EurekAlert – “For patients with autoimmune lupus, diet and probiotics are the two relatively easy and acceptable approaches that can potentially improve disease management through modulating the gut microbiota…” Systemic lupus erythematosus, a chronic autoimmune disease commonly referred to as lupus or SLE, has been compared to volatile, unprovoked brawls within the body. The disease, which has no cure, operates much like an allergic reaction gone awry: When activated, the immune system also attacks the body’s healthy cells, tissues, and organs, causing inflammation and producing a host of symptoms that, though unique to each person, are universally called flares. A highly gender-biased disease, lupus afflicts females some nine times more than males. Because of the disease’s unpredictable turns and debilitating flares – the risks of which are elevated in postpartum women – females with the disease are often advised to avoid pregnancy altogether. To understand this higher risk of severe flares and ultimately help women with lupus experience healthy pregnancies and successful outcomes, a team of researchers in the Department of Biomedical Sciences and Pathobiology (DBSP) at the Virginia-Maryland College of Veterinary Medicine explored the possible role of gut microbiota in the link between pregnancy and the exacerbation of lupus. The team’s findings, “Pregnancy and lactation interfere with the response of autoimmunity to modulation of gut microbiota,” were recently published in the online journal Microbiome. “There are 38 trillion bacteria living in the gut of an average person, collectively called the gut microbiota,” said Xin M. Luo, associate professor of immunology in DBSP and lead author of the paper with Qinghui Mu, formerly a DBSP postdoctoral fellow and now a postdoctoral research fellow in immunology and rheumatology at Stanford University School of Medicine. “Disturbance of the gut microbiota exists in the pathogenesis of many autoimmune diseases, including lupus.” Identifying gut microbiota’s role in heightened flares among pregnant women with lupus, however, was uncharted territory. Working with the lead authors as members of the DBSP research team were Ph.D. student Xavier Cabana-Puig; visiting scholar Jiangdi Mao; Ph.D. student Leila Abdelhamid; clinical associate professor of anatomic pathology Thomas E. Cecere; Translational Biology, Medicine, and Health Graduate Program Ph.D. student Brianna Swartwout; Professor Haifeng Wang of the College of Animal Science at Zhejiang University, China; and Professor Christopher M. Reilly, discipline chair for cellular biology and physiology at the Edward Via College of Osteopathic Medicine. The research team examined the changes of gut microbiota structure with or without the experience of pregnancy, as well as the differential responses of the immune system to the same microbiota-modulating strategies in unaffected versus postpartum lupus-prone mice. The results indicate that the strategies benefitting the unaffected mice actually worsened lupus disease in postpartum mice. “Our findings suggest that the gut microbiota may regulate lupus flares in pregnant women,” Luo said of the team’s research. “Our work helps to uncover the mechanisms underlying pregnancy-induced disease flares and offers the possibility of developing new therapeutic strategies for pregnant women with lupus.” The ultimate goal of her team’s research, Luo explains, is to identify beneficial and pathogenic gut bacterial species and to develop therapeutic strategies that modulate the gut microbiota community toward a beneficial effect. “For patients with autoimmune lupus, diet and probiotics are the two relatively easy and acceptable approaches that can potentially improve disease management through modulating the gut microbiota,” Luo said. “But it is challenging to achieve this goal due to the complexity of the disease pathologies, the complexity of gut microbiota, and the differences of gut microbiota communities among individuals.” For its next steps, the research team plans to investigate the interaction between sex hormones and gut microbiota in regulating lupus pathogenesis. “Women experience hormonal changes, which include sex hormones, during pregnancy and postpartum,” said Luo. “In addition, lupus has a strong female bias, suggesting a role for sex hormones in the disease.” According to Luo, future investigations will focus on lupus nephritis, the leading cause of mortality in lupus patients, to further delineate the role of gut microbiota in the link between pregnancy and exacerbated lupus. To read the original article click here.

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